尿毒症血液透析合并急性左心衰患者心肌酶的变化  

Evaluation of the Changes of Cardiac Enzymes in Uremic Hemodialysis Patients with Acute Left Heart Failure

作　　者：娄爱菊[1] 王簕[2] 陈锐[1] 吴国锋[1] 李怡[1] 

机构地区：[1]广州医学院荔湾医院肾内科,广东广州510170 [2]广州医科大学第三附属医院骨科,广东广州510150

出　　处：《临床医学工程》2013年第7期800-801,共2页Clinical Medicine & Engineering

基　　金：国家自然科学基金项目(31200726)

摘　　要：目的探讨尿毒症血液透析合并急性左心衰患者心肌酶升高的临床意义。方法尿毒症并急性心力衰竭患者38例为心衰组,同期未发生心衰的尿毒症患者40例为对照组,检测两组肌酸磷酸激酶(CK)、肌酸磷酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、谷草转氨酶(AST)、肌钙蛋白(cTnT)的变化。结果心衰组出现了不同程度的心肌酶谱的升高,以CK、CK-MB及HBDH升高最为显著(P<0.01),LDH及AST未见明显升高(P>0.05)。对照组仅个别患者出现CK、CK-MB及HBDH升高。但两组患者均有cTnT的升高,心衰组出现率为34.2%,对照组为30%。结论尿毒症合并急性左心衰患者的心肌酶出现明显升高,检测心肌酶的变化对于尿毒症患者的预后有重要意义。Objective To explore the significance of the changes of cardiac enzymes in uremic hemodialysis patients with acute left heart failure （AHF）. Methods Thirty-eight uremia patients with AHF were chosen as the AHF group, and 40 uremia patients without AHF were as the control group. The changes of creatine kinase （CK）, isoenzyme of creatine kinase-MB （CK-MB）, lactate dehydrogenase （LDH）, hydroxybutyrate dehydrogenase （HBDH）, aspartate aminotransferase （AST）, cardiac troponin T （cTn T） were tested through the blood specimen. Results In the AHF group, cardiac enzymes increased. Especially, the value of CK, CK-MB and HBDH increased significantly when compared with the control group （P 〈0.01）. However, the value of LDH and AST did not increase significantly （P 〉0.05）. In the control group, CK, CK-MB and HBDH increased only in several patients. The value of cTn T increased in both groups. The occurrence rate of heart failure was 34.2% in AHF group and 30% in the control group. Conclusions The cardiac enzymes increase significantly in uremia patients with AHF. Therefore, the detection of the changes of cardiac enzymes is important for prognosis of patients with uremia.

关 键 词：尿毒症 心力衰竭 心肌酶 

分 类 号：R692.5[医药卫生—泌尿科学]