无抽搐电痉挛治疗发作延长患者心肌损伤标志物的变化  

Biochemical markers of myocardial injury in patients of prolonged seizures after modified eleetroconvulsive therapy

作　　者：付华斌[1] 周小东[1] 刘知源[1] 路巍[1] 祁革[1] 陈峰[1] 罗屯勇[1] 宁卫东[1] 

机构地区：[1]解放军白求恩国际和平医院256临床部北京军区精神疾病研究防治中心,正定050800

出　　处：《中华行为医学与脑科学杂志》2011年第2期134-136,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：基金项目：北京军区计划课题（06BJ013）

摘　　要：目的观察无抽搐电痉挛治疗（MECT）后抽搐发作延长的发生率和心肌损伤标志物的变化。方法26例MECT后抽搐发作延长者为发作延长组，41例MECT后无抽搐发作延长者为正常发作组，同时设31例未行MECT者为对照组。分别在发作延长、正常发作后即刻、发作后3h和次日留取血标本，对照组即刻留取血标本测量心肌损伤标志物。包括磷酸肌酸激酶（CK）、磷酸肌酸激酶同功酶（CK—MB）、乳酸脱氢酶（LDH）、α-羟丁酸脱氡酶（a—HBDH）和心脏肌钙蛋白（cTnT），并对3组间的心肌损伤标志物进行比较。结果发作延长组与正常发作组和对照组比较，CK—MB（即刻）、α—HBDH（即刻、3h和次日）、LDH（即刻、3h）差异有显著性（P〈0．05）；发作延长组的即刻CK值高于对照组（P〈0．05）。正常发作组与发作延长组cTnT阳性率分别为17．1％和30．8％，二者比较差异无显著性。结论MECT过程中及其后可能存在的相对低氧状态，是否可能导致心肌微小损伤需引起警惕。Objective To observe the prevalence of prolonged seizures and the changes of biochemical markers of myocardial injury in patients with prolonged seizures after modified electroconvulsive therapy（MECT）. Methods Patients treated with MECT or simulated ECT were divided into three groups. Group Ⅰ, 26 patients, experienced at least one prolonged seizure after MECT;group Ⅱ , 41 selected patients, had not prolonged seizures at all during a course of MECT treatments and group Ⅲ, 31 patients, received simulated ECT. Biochemical markers of myocardial injury, including phosphocreatine kinase （ CK ） , MB isoenzyme of phosphocreatine kinase （ CK-MB）, lactate dehydrogenase （ LDH ）, α-hydroxybutyratc dehydrogenase （ α-HBDH ） and cardiac troponin （cTnT） ,were measured immediately, 3 hours later and on the following day after the first prolonged seizure for group I , the same time points as group I after the first treatment of MECT for group Ⅱ , immediately after simulated ECT for group Ⅲ. These indexes were compared between the patients of three groups. Results The positive rate of cTnT was 30.8% （8/26） and 17. 1% （7/4l）in group Ⅰ and Ⅱ respectively, but no difference was found （P 〉 0.05 ）. CK measured immediately after MECT in patients of group I was significantly higher than that of group m （P〈0. 05 ）. CK-MB （ immediately）, LDH （ immediately and 3 hours later） and α-HBDH （ immediately, 3 hours later and on the following day） in patients of group I were significantly higher thau thosc of group Ⅱ and m meas- ured after MECT or simulated ECT（P 〈 0. 05 ）. Conclusion More attention should be paid that absolute or relative hypoxemia may lead to minor myocardial injury.

关 键 词：电痉挛治疗 抽搐发作延长 心肌损伤标志物 

分 类 号：R541[医药卫生—心血管疾病]