心肌肌钙蛋白I和心肌酶在背驮式肝移植术麻醉中的表达及意义分析  

Expression and significance analysis of cardiac troponin I and myocardial enzyme in the anesthesia of piggy-back orthotopic liver transplantation

作　　者：江朝秀[1] 倪玉霞[1] 彭劲松[1] 

机构地区：[1]广西医科大学第一附属医院麻醉科,南宁530021

出　　处：《中国当代医药》2015年第23期95-97,共3页China Modern Medicine

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2007074);广西壮族自治区卫生厅自筹经费科研课题(Z2005044)

摘　　要：目的 探讨心肌肌钙蛋白I（cTnI）和心肌酶在背驮式肝移植术麻醉中的表达及意义。方法 选取本院2007年1月-2013年1月行同种异体原位肝移植术的14例患者作为研究对象,分别于切皮时、阻断门静脉30 min、开放门静脉30 min、术毕、术后24 h和术后48 h抽取静脉血测定cTnI、CK和CK-MB水平。结果 开放门静脉30 min、术毕时的cTnI水平显著高于切皮时,差异有统计学意义（P〈0.05）。术后24、48 h的CK水平显著高于切皮时,差异有统计学意义（P〈0.01）。开放门静脉30 min、术毕时的CK-MB水平显著高于切皮时,差异有统计学意义（P〈0.05）,而且数据均大于正常值。14例患者术中心电监护无明显心肌缺血改变,术后48 h随访无心脏不良并发症。结论 在背驮式肝移植术中,cTnI比CK、CK-MB反映心肌损伤的特异性更高,更准确可靠,本研究患者围术期均无明显心肌损伤。Objective To explore the expression and significance of cardiac troponin I and myocardial enzyme in the anesthesia of piggy-back orthotopic liver transplantation. Methods 14 cases with orthotopic liver transplantation from January 2007 to January 2013 in our hospital were selected as the research objects.The level of cardiac troponin I（cTnI）,CK and CK-MB at points-skin incision,clamping the portal vein for 30 min,unclamping the portal vein for 30 min,end of operation,postoperative 24 and 48 h was measured respectively. Results The level of cTnI at clamping the portal vein for 30 min and end of operation was higher than that at points-skin incision,with significant difference（P〈0.05）.The level of CK after operation at 24,48 hours was higher than that at points-skin incision,with significant difference（P〈0.01）.The level of CK-MB at clamping the portal vein for 30 min and end of operation was higher than that at points-skin incision,with significant difference（P〈0.05）,and all the level of CK-MB exceeded normal range.There was no obvious changes of myocardial ischemia in 14 patients,and no complication was followed up after 48 hours. Conclusion During perioperation of piggy-back orthotopic liver transplantation,c Tn I can reveal myocardial injury more accurately and responsibly than CK,CK-MB.There is no obvious myocardial injury in the perioperative period of this study.

关 键 词：背驮式肝移植 心肌肌钙蛋白I 心肌酶 心肌损伤 

分 类 号：R614[医药卫生—麻醉学]