颅脑损伤患者血清cTnI与心肌酶学改变的临床研究

目的：探讨颅脑损伤患者血清cTnI和心肌酶学改变的临床意义。方法：我院近期收治的脑外伤患者60例为A组,健康体检者20例为B组,测定并比较A、B组血清CK、CKMB、LDH、HBDH值;同时将A组按GCS评分分为A1（GCS3-5分）、A2（GCS6-8分）、A3（GCS9-15分）组,并进行亚组组间比较和血清cTnI阳性率分析。结果：A组与B组心肌酶比较均有统计学意义（P〈0.05）;A2、A3组与A1组比较,心肌酶均有统计学意义（P〈0.05或P〈0.01）;A3组与A2组比较CK、CKMB差异有显著性（P〈0.01）,HBDH、LDH没有统计学意义（P〉0.05）。A1、A2、A3血清cTnI阳性率分别为58.3%（14/24）、13.6%（3/22）和7.1%（1/14）。结论：颅脑损伤患者存在心肌功能损伤,其程度与颅脑损伤程度相关,临床治疗应增加心肌保护性措施。

The Clinical Research of Serum Cardiac Troponin I and Myocardial Enzyme in Patients with Traumatic Brain Injury

Objective：To investigate the clinical significance of cardiac troponin I（cTnI） and myocardial enzyme in patients with traumatic brain injury.Methods：Sixty patients with brain injured were admitted as group A and twenty healthy patients as group B,the myocardial enzyme（ME） were measured and compared between group A and B.At the same time,the group A were subdivided into A1（GCS 3~5）、A2（GCS 6~8）、A3（GCS 9~15）according to GCS,the level of ME and cTnI positive incidence were compared in the subgroups.Results：The comparison between group A and B had statistics significance（P〈0.05）;the comparison between the subgroups also had statistics significance（P〈0.05 or P〈0.01）;the comparison between group A3 and A2 had statistics significance in CK、CKMB（P〈0.01）,but in not HBDH、LDH（P〉0.05）.cTnI positive incidence in A1、A2 and A3 was58.3%（14/24）、13.6%（3/22）和7.1%（1/14） respectively.Conclusion：There is cardiac dysfunction in patients with traumatic brain injury.The extent and degree of the dysfunction is related to the brain injury.The clinical treatment should has the myocardial protection measures.