心肌肌钙蛋白Ⅰ对体外循环期心肌损伤的判定价值附视频

被引:68
作者
王萍
房秀生
机构
[1] 重庆医科大学附属第一医院麻醉科
关键词
心肺转流术; 心肌; 肌钙蛋白I; 心肌再灌注损伤; 诊断;
D O I
暂无
中图分类号
R654.1 [体外循环及复苏术];
学科分类号
摘要
目的 探讨心肌肌钙蛋白I(cTnI)对体外循环期心肌损伤的判定价值。方法  2 0例心内直视手术病人随机分为两组 ,冷晶体停跳组 (组Ⅰ ) ,冷氧合血停跳组 (组Ⅱ ) ,每组 10例 ,分别于围术期多个时点采取中心静脉血 ,测定血清cTnI、CK及CK MB的水平 ,并观察缺血前后心肌超微结构变化。结果 术前两组的cTnI、CK及CK MB水平均在正常范围 ,开放主动脉后 1h至术后 2 4h达峰值 ,其后缓慢下降。术后 2 4h、48h冷氧合血停跳组cTnI水平明显低于冷晶体停跳组 (P <0 .0 5 ) ,CK MB在开放主动脉后 1h冷氧合血停跳组低于冷晶体停跳组。cTnI峰值浓度与主动脉阻时间呈直线正相关。结论 cTnI判定心内直视手术围术期心肌损伤的敏感性及特异性明显优于CK、CK MB ,对围术期心肌缺血损伤的诊断、预后及心肌保护效果的评价具有重要的临床价值
引用
收藏
页码:8 / 12
页数:5
相关论文
共 8 条
  • [1] Use of cardiac troponin I to diagnose perioperative myocardial infarction in coronary artery bypass grafting. Mair J,Larue C,Mair P,et al. Clinical Chemistry . 1994
  • [2] Cardiac-specific troponin-I radioimmunoassay in the diagnosis of acute myocardial infarction. Cummins B,Auckland ML,Cummins P,et al. American Heart Journal . 1987
  • [3] To T or not to T, that is the question. Collinson PO. Clinical Chemistry . 1997
  • [4] Cardiac-specific immunoenzymometric assay of troponin I in the early phase of acute myocardial infarction. Larue C,Calzolari C,Bertinchant JP,et al. Clinical Chemistry . 1993
  • [5] Cardiac troponins in patients with renal dysfunction. Collinson PO,Hadcocks L,Foo Y,et al. Annals of Clinical Biochemistry . 1998
  • [6] Perioperative preservation of myocardial ultrastructure and high-energy phosphates in man. Balderman SC,Bhayana JN,Binette P,et al. Journal of Thoracic and Cardiovascular Surgery . 1981
  • [7] Several conditions causing elevation of serum CK-MB and CK-BB. Tsung SH. American Journal of Clinical Pathology . 1981
  • [8] Biochemical markers of myocardial injury: is MB creatine kinase the choice for the 1990s. Adams JE,Abendschein DR,Jaffe AS. Circulation . 1993