心肌酶谱与肌钙蛋白Ⅰ对老年冠心病非心脏手术围术期不良事件的预测价值  

Predictive value of myocardial enzymes and troponin Ⅰ to perioperative adverse events in the elderly patients with coronary artery disease undergoing non-cardiac surgery

作　　者：俞瑾[1] 叶建荣[1] 郑宏[1] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐市830054

出　　处：《中华实用诊断与治疗杂志》2011年第10期960-962,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区科技支疆项目(200991126);新疆维吾尔自治区重点学科(内科学)建设经费(2004-2008)

摘　　要：目的探讨围术期监测心肌酶谱与肌钙蛋白Ⅰ对老年冠心病患者实施非心脏手术预测围术期不良事件的价值。方法 223例择期行非心脏手术老年冠心病患者,根据围术期是否发生不良事件分为发生不良事件组(A组)与未发生不良事件组(B组),比较2组术前及术后3 d内心肌酶谱及肌钙蛋白I水平。结果 2组术前心肌酶谱各项指标与肌钙蛋白I水平均在正常值范围;术后3 d内2组肌酸激酶水平较术前升高(P<0.05),但2组间比较差异无统计学意义(P>0.05);术后肌钙蛋白Ⅰ水平逐渐升高,A组超出正常值范围,B组仍在正常值范围;与术前比较,差异均有统计学意义(P<0.05),且A组高于B组(P<0.05)。结论老年冠心病非心脏手术患者围术期检测心肌酶谱对预测不良事件价值有限;术后3 d内检测肌钙蛋白I对早期发现围术期不良事件有一定预测价值。Objective To investigate the predictive value of myocardial enzymes and troponin I to perioperative adverse events in the elderly patients with coronary artery disease undergoing non-cardiac surgery.Methods A total of 223 elderly patients with coronary artery disease undergoing non-cardiac surgery were divided into group with adverse event（group A） and group without adverse events（group B）.The myocardial enzymes and troponin I were detected and compared between two groups preoperatively and in postoperative three days.Results The levels of myocardial enzymes and troponin I in both groups were normal before operation.The level of creatine kinase in both two groups was higher in postoperative three days（P0.05）,but there was no significant difference between two groups（P0.05）.The level of troponin I gradually increased in postoperative three days,exceeded the normal range in group A,and was still within the normal range in group B.There was significant difference in troponin I between two groups（P0.05） and between before and after operation（P0.05）.Conclusion Detection of myocardial enzymes before operation provides limited information for predicting the perioperative adverse events in the elderly patients with coronary artery disease undergoing non-cardiac surgery.Detection of troponin I in the postoperative three days has predictive value to the early detection of perioperative adverse events.

关 键 词：冠心病 老年 非心脏手术 心肌酶谱 肌钙蛋白I 

分 类 号：R541.4[医药卫生—心血管疾病]