心脏体外循环手术前后血清肌钙蛋白Ⅰ的变化  

Changes in cardiac troponin I during extracorporeal circulation

作　　者：赵继梅[1] 刘相东[1] 刘春[1] 焦玉莲[1] 

机构地区：[1]山东省立医院检验科,济南250021

出　　处：《中华检验医学杂志》2001年第6期357-358,共2页Chinese Journal of Laboratory Medicine

摘　　要：目的　通过动态观察血清心肌肌钙蛋白I(cTnI)及肌酸肌酶同工酶 (CK MB)的变化 ,以评价心脏体外循环手术对心肌的可能影响。方法　对 30例行经体外循环手术的心脏病患者分别测定其术前、术后 6、12、2 4、48和 72h的血清 ,采用Bodor等改良的单克隆抗体夹心ELISA法测定cTnI浓度 ,用免疫抑制酶动力学方法测定CK MB水平并进行分组比较。结果　 2 8例心脏病患者术前血清cTnI及CK MB均正常 ,cTnI( x±s) (5 .2 0± 2 .80 ) μg/L ,CK MB( x±s) (10 .75± 4.70 )U/L ,术后 6hcTnI及CK MB均开始升高 ,cTnI 8.16～ 15 .5 6 μg/L ,CK MB 2 4.1～ 34 .3U/L。 12～ 2 4h达峰值 ,cTnI2 8 80～ 71.30 μg/L ,CK MB 5 5 .6 0～ 71.30U/L。开始升高及达峰值的时间cTnI与CK MB相似。 48～72h血清CK MB渐降至正常 ,49.70～ 2 2 .80U/L ,72h后血清cTnI仍高于正常值 ,9.40～ 19.80 μg/L。2例患者术前术后血清cTnI及CK MB均高于正常值。结论　行心脏体外循环手术 ,可能会造成心肌因缺血而损伤 。Objective To detect the changes in cTnI and CK MB during extracorporeal circulation and the myocardial injury by extracorporeal circulation. Methods The value of cTnI and CK MB was determined in 30 persons during extracorporeal circulation. We divided them into 6 groups according to pre operation, 6, 12, 24, 48 and 72 hours after operation. Modified method (Bodor et al) was used to detect cTnI, and immune suppression method to detect CK MB. Results cTnI and CK MB were, cTnI ( ±s ) (5.20±2 80) μg/L,CK MB ( ±s ) (10.75±4.70) U/L in 28 persons. They elevated 6 hours after operation. 12 24 hours after operation cTnI and CK MB increased to the maximum, cTnI 28.80 71.30 μg/L,CK MB 55.60 71.30 U/L. During 48 72 hours, CK MB decreased to normal, 49.70 22.80 U/L. cTnI was 9.40 19.80 μg/L 72 hours after operation. Conclusion Extracorporeal circulation may cause myocardial diseases. cTnI is a more sensitive biochemical marker for myocardial diseases.

关 键 词：肌钙蛋白 体外循环 心肌疾病 

分 类 号：R654.2[医药卫生—外科学]