慢性肺源性心脏病急性期低氧血症患者血清心肌酶活性变化及临床意义  

The changes of the serum-myocardial enzymes activity and their clinical significance of chronic pulmonary heart disease in acute phase with Hypoxemia

作　　者：陈明友[1] 潘庭荣[2] 

机构地区：[1]四川省内江市隆昌县人民医院检验科,642150 [2]四川省泸州市人民医院检验科,646000

出　　处：《检验医学与临床》2013年第7期792-794,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨慢性肺源性心脏病(肺心病)急性加重期低氧血症患者5种血清心肌酶活性变化及其临床意义。方法以54例慢性肺心病患者为肺心病组(实验组),并按低氧程度分为轻、中、重3组;以80例健康人为健康对照组。分别测定血清中肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)、天门冬氨酸氨基转移酶(AST)活性及动脉血氧分压(PaO2),并对结果进行分析。结果 (1)肺心病组血清各项心肌酶学指标均明显高于健康对照组。(2)肺心病轻、中、重3组血气分析结果:轻度18例,PaO2(69.61±10.13)mm Hg;中度24例,PaO2(41.25±5.34)mm Hg;重度12例,PaO2(27.33±3.11)mm Hg,差异有统计学意义(P<0.05)。(3)肺心病组治疗后较治疗前各项酶学指标明显降低。(4)肺心病急性加重期死亡组心肌酶均值较存活组明显增高。结论血清心肌酶活性的变化和肺心病病情严重程度密切相关,其活性测定是评价疗效和判断预后的重要参考指标。Objective To explore the changes of 5 kinds of serum-myocardial enzymes activity and their clini- cal significance of chronic pulmonary heart disease in acute phase with hypoxemia. Methods 54 patients with chronic pulmonary heart disease were selected as experimental group, and divided into light ,medium and heavy group by the degree of hypoxemia. 80 cases were chosen as healthy control group. Serum-myocardial enzyme include creatine phos- phatase kinase （CK） and iso-enzyme MB （CK-MB）, lactate-dehydrogenase（LDH）, a-hydroxybutyrate-dehydrogenase （HBDH）, and aspartate-aminotransferase （AST） in serum were measured respectively and the blood gas analysis was performed to determine the PaO2. Results （1）The levels of CK,CK-MB, LDH, HBDH and AST in chronic pulmo- nary heart disease group were higher than those of healthy control group in varying degrees. （2）According to the a- nalysis of variance of the light, medium and heavy groups of experimental group, the levels of 6 enzymes were signifi- cantly higher and the more hypoxic severely,the more obviously enzyme activity increased. （3）All the sera enzymes contents of experimental group after treatment were significantly lower than those before treatment. （4）The average values of 5 serum-myocardial enzymes activity were significantly higher in death group than those in survival group. Conclusion Serum-myocardial enzyme activity and its changes are closely related to the degree of the severity of the chronic corpulmonale and play an important index in the evaluating of the treatment effect and determining the prog- nosis of the disease.

关 键 词：慢性肺心病 心肌酶 低氧血症 

分 类 号：R541.5[医药卫生—心血管疾病]