动态监测LDH和AST在早期诊断骨筋膜室综合征中的价值  

Significance of detecting lactate dehydrogenase and aspartate aminotransferase in early diagnosis of compartment syndrome

作　　者：沈海琦[1] 刘燚[1] 夏永祥[2] 朱和平[1] 朱超[1] 

机构地区：[1]南京医科大学附属南京第一医院骨科,210006 [2]南京医科大学附属南京第一医院检验科,210006

出　　处：《江苏医药》2009年第5期510-512,621,共4页Jiangsu Medical Journal

基　　金：南京市重大科技项目基金资助(ZKX05007)

摘　　要：目的探讨相关生化指标检测在骨筋膜室综合征早期诊断及病情评估中的作用。方法四肢骨筋膜室综合征患者40例,患者受伤入院后2、24 h及1、2、3、4周连续动态检测血浆乳酸脱氢酶(LDH)、谷草转氨酶(AST)浓度。术中及术后1、2、3周取患肢受累肌肉组织行病理检查。结果患者受伤2 h后,血浆LDH、AST浓度即急剧升高,分别为正常值的2和4倍。24 h后各项指标达到峰值,LDH和AST分别达正常值的4和10倍。1周后,LDH和AST仍明显高于正常值(P<0.01)。病理显示肌肉标本明显不可逆性坏死。结论LDH和AST的变化能客观的反映病情严重程度。动态连续监测这些指标能为早期诊断及评估骨筋膜室综合征病情提供有效帮助。Objective To study the significance of detecting lactate dehydrogenase（LDH） and aspartate aminotransferase（AST） in early diagnosis of compartment syndrome（CS）. Methods LDH and AST were detected dynamically in 40 cases with CS at 2 and 24 h on the 1^st, 2^nd , 3^rd and 4^th week after injury. The muscle preparations of affected extremities were taken for biopsy during surgery and on the 1^st ,2^nd and 3^rd week after operation. Results The levels of LDH and AST increased sharply at 2h after injury,which were 2 and 4 times of normal values, respectively. The increases of LDH and AST reached the peak values at 24h after injury, which were 4 and 10 times of normal values, respectively, and still higher than the normal one week later （P〈 0.05）. Pathological changes of muscles were irreversible necrosis. Conclusion The changes of LDH and AST can reflect the progression of disease. Monitoring dynamicly the changes of LDH and AST is helpful in early diagnosing and evaluating pathogenetic condition of compartment syndrome.

关 键 词：骨筋膜室综合征 乳酸脱氢酶 谷草转氨酶 

分 类 号：R683[医药卫生—骨科学]