心肌肌钙蛋白T对体外循环心内直视手术不同停搏液对心肌损伤的判定价值  

CARDIAC TROPONIN T FOR THE DIAGNOSIS OF MYOCARDIAL INJURY IN DIFFERENT MEASURE IN OPEN HEART SURGERY UNDERGOING CARDIOPULMONARY BYPASS

作　　者：杜雪江[1] 宿瑞俊[2] 温再和[1] 朱宪明[3] 

机构地区：[1]内蒙古医学院附属医院麻醉科,内蒙古呼和浩特010050 [2]内蒙古医学院附属医院检验科,内蒙古呼和浩特010050 [3]内蒙古医学院附属医院心胸外科,内蒙古呼和浩特010050

出　　处：《内蒙古医学院学报》2007年第5期340-342,共3页Acta Academiae Medicinae Neimongol

基　　金：内蒙古自治区自然科学基金(200607010901)

摘　　要：目的:探讨心肌肌钙蛋白T(cTnT)对体外循环心内直视手术不同灌注方法心肌损伤的判定价值。方法:40例心瓣膜置换术病人随机分为两组,冷晶体停搏液组(A组)及含血停搏液组(B组),每组20例,分别于围手术期多时点采取静脉血,测定血清cTnT。结果:术前两组的cTnT水平均在正常范围,开放主动脉后1h至术后24h达峰值,其后缓慢下降。术后24h、48h,B组cTnT水平明显低于A组。cTnT峰值浓度与主动脉阻断时间呈正相关。结论:cTnT是判定心内直视手术围手术期心肌损伤的敏感指标,含血停搏液比晶体停搏液具有更好的心肌保护效果。Objective：To evaluate the clinical value of myocardial ischemic injury during open heart surgery of cardiac troponin T（cTnT） in the diagnosis undergoing cardiopulmonary bypass （ CPB ）. Methods：Forty patients undergoing cardiac valve replacement operation were randomly divided into two groups： group A （cold crystalloid cardioplegia, n = 20） and group B （blood cardioplegia, n = 20）. The central venous blood samples were taken at various times during perioperation for measuring the serum levels of cTnT. Results： cTnT levels were normal before operation, increased significantly following aorta unclamping, reached the peak lh after aorta unclamping to 24h after operation ,and decreased progressively to be normal in two groups. The serum cTnT level was significantly lower in group B than that in Group A 24h and 48h after operation. There was positive significant correlation between aorta cross - clamping time and cTnT peak level. Conclusion： cTnT could be used to evaluate the degree of myocardial injury and myocardial protective effect in open heart surgery during CPB.

关 键 词：体外循环 心肌肌钙蛋白T 心肌损伤 

分 类 号：R654.1[医药卫生—外科学]