心肌酶和cTnI对急性一氧化碳中毒后心肌损伤的诊断价值  

Diagnostic values of CK and cTnI in myocardial injury after ACOP

作　　者：陈士轩 牛红霞[1] 褚晓雯[1] 肖青[1] 

机构地区：[1]首都医科大学电力教学医院急诊科,北京100073

出　　处：《川北医学院学报》2015年第6期745-747,共3页Journal of North Sichuan Medical College

基　　金：中国高校医学期刊临床专项(11523954)

摘　　要：目的:评估肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)和肌钙蛋白(cardiac troponin,c Tn I)对急性一氧化碳中毒(acute carbon monoxide poisoning,ACOP)心肌损伤的诊断价值。方法:选取急性ACOP患者66例设为ACOP组,健康体检者39例作为对照组。比较两组血清CK、CK-MB及c Tn I水平。同时比较ACOP轻度中毒、中度中毒和重度中毒3组患者血清上述3指标值。结果:ACOP组CK、CK-MB、c Tn I水平均显著高于对照组,差异均有统计学意义(P<0.01)。轻度中毒组c Tn I水平高于对照组,差异有统计学意义(P<0.01);中、重度中毒组CK、CK-MB、c Tn I水平均高于对照组及轻度中毒组,差异均有统计学意义(P<0.01);重度中毒组CK-MB、c Tn I水平高于中度重度组,差异有统计学意义(P<0.01)。结论:c Tn I对ACOP后心肌损伤的诊断价值明显优于CK、CK-MB,为判断ACOP患者心肌损伤程度、评估病情的重要指标。Objective： To evaluate the diagnostic values of creatine kinase（ CK）,creatine kinase isoenzyme（ CK-MB） and cardiac troponin（ c Tn I） in myocardial injury after acute carbon monoxide poisoning（ ACOP）. Methods： A total of 66 ACOP patients and 39 healthy people undergoing physical examination served as ACOP group and control group,respectively. Levels of serum CK,CK- MB and c Tn I were compared between two groups. Meanwhile,the levels of above 3 indexes were also compared among mild,moderate and severe poisoning groups. Results： ACOP group was evidently higher in CK,CK-MB and c Tn I levels than control group,and the differences were significant（ P〈0. 01）. Mild poisoning group was markedly higher than control group in c Tn I level（ P〈0. 01）; moderate and severe poisoning groups were prominently higher in CK,CK-MB and c Tn I levels than control group and mild poisoning group（ P〈0. 01）; and severe poisoning group was obviously higher in CK-MB and c Tn I levels than moderate poisoning group,and there was significant difference（ P〈0. 01）. Conclusion： c Tn I is superior to CK and CK-MB in the diagnosis of myocardial injury after ACOP,and is an important index for the diagnosis of myocardial injury severity and evaluation of disease conditions in ACOP patients.

关 键 词：急性一氧化碳中毒 心肌肌钙蛋白 心肌损伤 肌酸激酶 肌酸激酶同工酶 

分 类 号：R446.1[医药卫生—诊断学]