创伤性脾破裂患者不同病情及不同时间外周血肌酸激酶的变化

目的 :研究创伤性脾破裂患者不同病情及不同时间外周血肌酸激酶的变化.方法 :选择2013年1月~2015年12月在我院进行诊治的60例创伤性脾破裂患者为脾破裂组,60例非脾破裂的腹部外伤患者为腹部外伤组,40例体检健康者为对照组,对照组在体检当日检测心肌酶谱,另外两组分别于术前、术后2 h、术后12 h、术后1d、术后3 d及术后7 d检测心肌酶谱,比较三组心肌酶谱的检测结果.结果 :脾破裂组和腹部外伤组患者经过手术治疗后,全部痊愈出院,在住院期间及术后随访半年内均未发生心肌梗死;与对照组相比,脾破裂组和腹部外伤组术前酸激酶与其同工酶均明显升高,与腹部外伤组组相比,脾破裂组在不同时间的酸激酶与其同工酶均明显升高;Ⅲ、Ⅳ级脾破裂患者在不同时间外周血肌酸激酶均高于 Ⅰ、Ⅱ级患者,但差异均无统计学意义,Ⅲ、Ⅳ级患者在T0、T1、T2、T3,外周血肌酸激酶同工酶均明显高于 Ⅰ、Ⅱ级患者.结论 :创伤性脾破裂患者早期外周血肌酸激酶及其同工酶均升高,且肌酸激酶同工酶的变化与脾破裂损伤程度呈正相关,提示创伤性脾破裂早期可能发生了心肌损伤,应尽早检测并关注患者心肌酶谱的变化.

Change of peripheral blood creatine kinase in patients with traumatic splenic rupture in different conditions and different time

Objective Change of peripheral blood creatine kinase in patients with traumatic splenic rupture in different conditions and different time. Methods Selected 60 cases of patients with traumatic splenic rupture who were treated in our hospital from January 2013 to December 2015 asrupture group, 60 cases of patients with abdominal trauma but non-rupture were admitted to abdominal trauma group, 40 healthy person were enrolled to healthy control group. The myocardial enzymes were detected at before operation (T0), 2 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3), 3 d after op-eration (T4) and 7 d after operation (T5). Results After surgical treatment, the patients in rupture group and abdominal trauma were all cured, and did not happen postoperative myocardial infarction; compared with control group, the kinase isozymeof rup-ture group and abdominal trauma group were significantly increased, compared with abdominal trauma group, theacid kinase isozymein rupture group were significantly higher; the peripheral blood creatine kinase at different time in patients withⅢ, Ⅳgrade spleen rupture were higher than patients with Ⅰ, Ⅱgrade spleen rupture, but there were no statistically significant differ-ence, the blood creatine kinase isozyme in patients withⅢ, Ⅳ grade spleen rupture were significantly higher than patients with Ⅰ,Ⅱgrade spleen rupture. Conclusion The creatine kinase and creatine kinase isoenzyme levels of patients with traumatic rupture appear elevated at early stage, the change of them are positively associated with the degree of injury, traumatic spleen rupture may prompt myocardial injury, it should be concerned myocardial enzymes changes as early as possible.