先天性心脏病患者围术期心肌酶的动态变化  

Perioperative changes of myocardial enzymes among congenital heart diseases

作　　者：陈长春[1] 沈宗林[1] 姬尚义[1] 刘志红[1] 胡应龙[2] 卢君强[3] 

机构地区：[1]广东省深圳市孙逸仙心血管医院外科,518001 [2]深圳市孙逸仙心血管医院检验科,518001 [3]深圳市南山区人民医院外科,518000

出　　处：《中国综合临床》2001年第4期285-287,共3页Clinical Medicine of China

摘　　要：目的深入揭示先天性心脏病患者心肌酶围术期变化的规律 ,更全面了解心肌受缺血影响的程度和恢复的情况。方法 5 3例先天性心脏病患者术前 1天 ,术后 1、3、5、8天晨分别取静脉血 ,测定血清天门冬酸氨基转移酶 ( AST) ,肌酸激酶及同功酶 ( CK,CK-MB) ,乳酸脱氢酶及同功酶 1( L DH,L DH1 )。结果择期手术的先天性心脏病患者术前 5种心肌酶均在正常范围 ;术后 1天达最高峰 ,术后 5天基本恢复正常 ;术后心肌酶的释放与心肌缺血时间存在着正相关关系 ,阻断时间超过 45分钟组的心肌酶释放明显高于阻断时间少于 45分钟组者 ,且前者心肌酶的恢复也较慢。结论术中应尽量缩短心肌的缺血时间以减少心肌细胞的损伤和心肌酶的释放。Objective To evaluate the extent of myocardial injury during operation and the recovery postoperatively and to investigate cardiac enzyme changes of congenital heart diseases perioperatively.Methods Venous blood samples from 53 patients of congenital heart diseases were taken on the day before operation,postoperative day 1,3,5 and 8 to measure the contents of AST,CK,CK MB,LDH and LDH 1.Results The values of AST,CK,CK MB,LDH and LDH 1 before operation were within the normal range.They peaked on the 1st postoperative day and almost all recovered to normal on the 5th day postoperatively.The release of myocardial enzymes was positively correlated with the aortic cross clamping time (CCT).The release of cardiac enzymes was more in patients with CCT longer than 45 minutes,and the recovery took a longer time,too,compared with the patients with CCT shorter than 45 minutes.Conclusion The shorter the aortic cross clamping time during operation is ,the less the release of cardiac enzymes and the faster the recovery of myocardial injury.

关 键 词：先天性心脏病 心肌酶 心内直视手术 体外循环 

分 类 号：R654.2[医药卫生—外科学]