血清心肌酶活性检测在新生儿窒息中的临床意义

目的分析血清酶活性检测对新生儿心肌损伤的诊断价值。方法对41例窒息新生儿（轻度窒息组20例和重窒息度组21例,20例无窒息新生儿作为对照组）进行血清酶活性检测。均于生后12~24h内采血,分别测定血清中天门冬氨酸转移酶（AST）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）的活性。结果轻、重度窒息组的AST、LDH、CK、CK-MB水平均较正常对照组明显升高。重度窒息组的AST、LDH、CK、CK-MB较轻度窒息组明显升高。结论心肌酶活性检测可作为窒息新生儿心肌损害的早期、灵敏、特异的重要指标。     

急性脑血管病并发心肌损害时心肌酶及心电图变化

目的观察急性脑血管病患者并发心肌损害时血清心肌酶、心电图的变化,分析其临床意义。方法用酶速率法测定急性脑血管病88例患者的血清心肌酶谱,包括肌酸激酶(CK)、心肌型肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH),同时进行心电图检查,并根据神经功能缺损程度分轻、中、重型组,多组间进行对比分析。结果急性脑血管病(脑梗死与脑出血组)患者血清心肌酶除CK-MB外,AST、CK、LDH、α-HBDH与正常对照组比较具有统计学意义(P0.05或P0.01);脑梗死与脑出血组血清心肌酶比较无统计学意义(P0.05);重型组血清心肌酶明显高于轻型组(P0.01);心电图阳性组与心电图阴性组血清心肌酶比较无统计学意义(P0.05)。结论急性脑血管病患者并发心肌损害,血清心肌酶有明显的改变,其变化与病情轻重有关。检测血清心肌酶有助于判断病情的轻重及预后。     

原发性甲状腺机能减退患者α-磷酸甘油脱氢酶、ATP及心肌酶谱的分析

目的观察甲状腺机能减退患者血清α-磷酸甘油脱氢酶、ATP及心肌酶谱的变化及判断病情。方法测定58例原发性甲状腺机能减退患者血清α-磷酸甘油脱氢酶、ATP及心肌酶谱,并与50例正常者进行比较。结果甲状腺机能减退患者血清ATP明显低于对照组(P<0.01),α-磷酸甘油脱氢酶活性、心肌酶谱中的肌酸激酶(CK)及其同工酶(CK-MB)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)水平明显增高,以CK最为显著(P<0.01)且与FT3、FT4呈显著负相关。结论甲状腺机能减退可致α-磷酸甘油脱氢酶、ATP、心肌酶谱的活性改变,且与甲状腺机能减退的程度有关,可作为判断甲状腺机能减退病情的指标。     

围产期窒息新生儿心肌损害的评价

目的:探讨宫内窘迫和/或伴产后窒息致新生儿缺氧、缺血性心肌损害时的酶学及心电图变化。方法:对照组(A组,20例),窒息新生儿分为产后窒息组(B组,29例)和宫内窘迫伴产后窒息组(C组,23例),测定其血清AST、CK-MB、LDH、αHBDH及ECG。结果:C组上述心肌酶分别明显高于B组和A组,P<0.01或<0.05),而B组的又高于A组(P<0.05)。C组的心电图变化明显多于B组(P<0.05)。结论:宫内窘迫伴产后窒息致心肌损害更加严重。     

心肌复极异常心电图表现与冠心病患者心肌酶谱指标的关系研究

目的探究心肌复极异常心电图表现与冠心病患者心肌酶谱指标的关系。方法选取2015年6月—2016年4月在清河县中心医院就诊的冠心病患者198例,分为稳定型心绞痛(SAP)组45例、不稳定型心绞痛(UAP)组78例、急性心肌梗死(AMI)组75例,另选取同期在本院体检健康者40例作为对照组。比较4组受试者心肌复极异常心电图表现及心肌酶谱指标〔天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及乳酸脱氢酶(LDH)〕,并比较不同心肌复极异常心电图表现患者心肌酶谱指标。结果 AMI组、UAP组和SAP组患者ST段异常、T波异常发生率高于对照组,AMI组和UAP组患者ST段异常、T波异常发生率高于SAP组,AMI组患者ST段异常、T波异常发生率高于UAP组(P0.05);AMI组患者V2导联Tp-Te间期长于UAP组、SAP组和对照组(P0.05)。SAP组患者血清CK水平高于对照组(P0.05),而SAP组患者与对照组受试者血清AST、CK-MB、LDH水平比较,差异无统计学意义(P0.05);AMI组和UAP组患者血清AST、CK、CK-MB及LDH水平高于对照组,AMI组患者血清AST、CK和CK-MB水平高于UAP组(P0.05),而AMI组和UAP组患者血清LDH水平比较,差异无统计学意义(P0.05)。ST段异常患者血清AST、CK、CK-MB及LDH水平高于无ST段异常患者,T波异常患者血清AST、CK、CK-MB及LDH水平高于无T波异常患者(P0.05)。结论心肌复极异常心电图表现与冠心病患者心肌酶谱指标升高有关。     

血清心肌损伤标志物在新生儿高胆红素血症中诊疗的临床意义

目的:探讨新生儿胆红素血症中高浓度胆红素水平对新生儿心肌损伤的影响。方法:选取2020年12月至2021年9月南京医科大学附属儿童医院收治的191例新生儿高胆红素血症患儿,根据血清总胆红素(TBIL)水平将其分为轻度、中度、重度3组,其中TBIL>290.7μmol/L的65例为重度组,TBIL 256.5～290.7μmol/L的52例为中度组,TBIL 205.2～256.6μmol/L的74例为轻度组,另选取同期健康新生儿49例为对照组。检测其血清TBIL、间接胆红素(IBIL)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸酶同工酶(CK-MB)、α-羟基丁酸脱氢酶(HBDH)水平,并采用Pearson相关分析TBIL、IBIL与心肌损伤标志物LDH、CK、CK-MB及HBDH水平之间的相关性。结果:重度组LDH、CK、CK-MB、HBDH分别为(492.538±117.720)μmol/L、(172.384±74.847)μmol/L、(41.769±8.556)μmol/L、(310.123±96.591)μmol/L;中度组LDH、CK、CK-MB、HBDH分别为(4...     

新生儿高胆红素血症心肌酶的变化分析

目的 探讨新生儿高胆红素血症能否引起心肌损伤。方法 同时检测74例高胆红素血症患儿静脉血的总胆红素和心肌酶：AST、乳酸脱氢酶（LDH）、肌酸激酶（CK）及其同工酶（CK-MB），α-羟丁酸脱氢酶（α-HBD）。患几经光照和/或输注白蛋白后，再次检测血清总胆红素和心肌酶谱。结果 治疗前的心肌酶各项指标高于正常值，治疗后AST、LDH、CK、α-HBD仍高于正常值，而CK-MB与正常参考值无差异。结论 高胆红素血症能引起心肌酶谱的升高，但不一定造成患儿心肌细胞不可逆损伤。     

阿托伐他汀联合丹参酮ⅡA磺酸钠注射液对冠心病心绞痛患者的影响

目的探讨阿托伐他汀联合丹参酮ⅡA磺酸钠注射液对冠心病心绞痛患者的影响。方法选取无锡市惠山区人民医院2015年1月—2016年6月收治的冠心病心绞痛患者60例,根据治疗方案分为对照组和观察组,每组30例。在常规治疗基础上,对照组患者予以阿托伐他汀治疗,观察组患者予以阿托伐他汀联合丹参酮ⅡA磺酸钠注射液治疗;两组患者均连续治疗2周。比较两组患者临床疗效、心电图疗效、治疗前后心肌酶指标[肌酸酶同工酶(CK-MB)、肌酸激酶(CK)、羟丁酸脱氢酶(HBDH)及乳酸脱氢酶(LDH)]及不良反应发生情况。结果观察组患者临床疗效及心电图疗效均优于对照组(P<0.05)。两组患者治疗前血清CK-MB、CK、HBDH及LDH水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清CK-MB、CK、HBDH及LDH水平低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿托伐他丁联合丹参酮ⅡA磺酸钠可有效提高冠心病心绞痛患者临床疗效及心电图疗效,降低心肌酶指标,且安全性较高。     

精神分裂症患者血清心肌酶检测及临床价值分析

目的分析在精神分裂症患者的病程中血清心肌酶检测的变化情况,为临床精神类疾病的诊治提供依据。方法选取我院2015年7月~2016年6月收治的首发精神分裂症患者103例作为本研究对象作为观察组,另取100例健康人作为对照组,分析观察组患者入院时静脉血天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)与对照组健康人和观察组治疗一个月后的相关检测数据做对比。结果观察组患者在入院时AST、LDH、CK、CKMB、α-HBDH检测结果与对照组相比均显著增高,差异有统计学意义(P0.05)。观察组患者在治疗1个月后,与治疗前相比,AST、LDH、CK、CK-MB、α-HBDH均下降,差异有统计学意义(P0.05)。结论精神分裂症患者血清心肌酶水平明显高出健康人群,可作为临床辅助诊断的一项标准,对患者的病情及预后判断有一定的临床价值。     

磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的疗效观察

目的探讨磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的临床疗效及其对患儿心肌酶谱的影响。方法选择2015年1月—2016年1月我院收治的毛细支气管炎合并心肌损害患儿86例,随机分成对照组与观察组,每组43例。两组均给予祛痰、止咳、平喘、抗感染及抗病毒等常规治疗,对照组在此基础上加用孟鲁司特钠;观察组在对照组的基础上再加用磷酸肌酸钠,两组疗程均为1周。观察并记录两组患儿的临床疗效,治疗前后心肌酶谱中磷酸肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)及α-羟基丁酸脱氢酶(HBDH)表达水平,以及不良反应情况。结果观察组治疗总有效率为93.0%,显著高于对照组的74.4%,差异有统计学意义(P0.05);治疗后两组患儿血清CK、CK-MB、AST、LDH及HBDH水平均显著改善,且观察组的改善程度明显优于对照组,差异有统计学意义(P0.05);同时两组患儿均无明显的不良反应。结论磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的疗效显著,可明显改善心肌酶谱水平。     

Anaerobic myocardial abscess following myocardial infarction

An anaerobic myocardial abscess due to Bacteroides fragilis developed in a 60-year-old man when he had an acute myocardial infarction while recuperating from surgery for a paracolonic abscess. Anaerobic bacteremia is a common event and may lead to infection in areas of low oxygen tension far removed from the original portal of entry.     

曲尼司特对心肌梗死后心肌间质纤维化的影响

目的探讨曲尼司特对兔心肌梗死后心肌间质纤维化干预作用。方法结扎左前降支制作兔心肌梗死模型,分实验组和对照组。3周后经胃管分别给予曲尼司特及安慰剂1月,心脏彩超评价心功能并检测血清转化生长因子（transform ing growth factor,TGF-β1）,I、III型胶原浓度及组织羟脯胺酸含量。结果实验组治疗前后心功能、心腔内径、室壁厚度明显改善,血清TGF-β1,I、III型胶原浓度及羟脯胺酸含量较对照组明显下降。结论曲尼司特可有效拮抗心肌梗死后心肌间质纤维化,预防心室重构。     

Transient myocardial ischaemia after acute myocardial infarction

The prevalence and characteristics of transient myocardial ischaemia were studied in 203 patients with recent acute myocardial infarction by both early (6.4 days) and late (38 days) ambulatory monitoring of the ST segment. Transient ST segment depression was much commoner during late (32% patients) than early (14%) monitoring. Most transient ischaemia (greater than 85% episodes) was silent and 80% of patients had only silent episodes. During late monitoring painful ST depression was accompanied by greater ST depression and tended to occur at a higher heart rate. Late transient ischaemia showed a diurnal distribution, occurred at a higher initial heart rate, and was more often accompanied by a further increase in heart rate than early ischaemia. Thus in the first 2 months after myocardial infarction transient ischaemia became increasingly common and more closely associated with increased myocardial oxygen demand. Because transient ischaemic episodes during early and late ambulatory monitoring have dissimilar characteristics they may also have different pathophysiologies and prognostic implications.     

Assessment of myocardial viability using myocardial contrast echocardiography

Myocardial contrast echocardiography (MCE) is a technique that uses microbubbles as a tracer during simultaneous ultrasound of the heart. The microbubbles can be used to provide quantitative information regarding the adequacy of myocardial blood flow (MBF), as well as the spatial extent of microvascular integrity. In acute myocardial infarction, MCE can identify the presence of collateral flow within the risk area, and can therefore predict preservation of myocardial viability and ultimate infarct size even prior to reperfusion. After reperfusion, the extent of microvascular no-reflow can be determined, and has significant implications for recovery of left ventricular function. In chronic ischemic heart disease, MCE has also been shown to successfully differentiate viable from necrotic myocardium. This technique can accurately predict recovery of function after revascularization. More importantly, MCE can be used to identify viable segments that may help to prevent infarct expansion and remodeling, and thus improve patient outcomes.     

Assessment of myocardial viability with myocardial contrast echocardiography

The application of noninvasive imaging techniques to assess myocardial viability has become an important part of routine management of patients with acute myocardial infarction and chronic coronary artery disease. Information regarding the presence and extent of viability may help identify patients likely to benefit from revascularization or therapy directed at attenuating left ventricular remodeling. Myocardial contrast echocardiography (MCE) is capable of defining the presence and extent of viability by providing an accurate assessment of microvascular integrity needed to maintain myocellular viability. It is especially suited for the spatial assessment of perfusion, even when myocardial blood flow is reduced substantially in the presence of severe epicardial stenoses or in a bed dependent on collateral perfusion. The routine use of MCE to evaluate viability in patients with acute and chronic coronary artery disease is now feasible with the advent of new imaging technologies and microbubble agents capable of myocardial opacification from venous injections. The utility of this technique for determining treatment strategies has not been established but is forthcoming.     

经静脉心肌声学造影评价心肌梗死后存活心肌的价值

目的　探讨经静脉心肌声学造影 (MCE)对心肌梗死后存活心肌的诊断价值。方法　 2 4例心肌梗死患者用二维超声评价室壁运动情况 ,同时经静脉进行MCE ,以 3个月后静态超声心动图左室心肌节段性运动改善为依据评价MCE对心肌梗死后存活心肌的诊断价值。结果　在 2 4例病人的 384个心肌节段中 ,运动异常节段 184个。在运动异常的 184个节段中 ,MCE1分 39段 ,0 5分 5 0段 ,0分 95段。 3个月复查 79个节段有运动改善 ,其中 39段来自MCE1分的心肌 ,4 0段来自MCE0 5分的心肌。MCE对预测心肌梗死后室壁运动改善的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为 :10 0 %、89 7%、84 8%、10 0 %和 94 6 %。结论　MCE能比较准确地预测心肌梗死后心肌的存活性     

Transient myocardial ischaemia after acute myocardial infarction.

The prevalence and characteristics of transient myocardial ischaemia were studied in 203 patients with recent acute myocardial infarction by both early (6.4 days) and late (38 days) ambulatory monitoring of the ST segment. Transient ST segment depression was much commoner during late (32% patients) than early (14%) monitoring. Most transient ischaemia (greater than 85% episodes) was silent and 80% of patients had only silent episodes. During late monitoring painful ST depression was accompanied by greater ST depression and tended to occur at a higher heart rate. Late transient ischaemia showed a diurnal distribution, occurred at a higher initial heart rate, and was more often accompanied by a further increase in heart rate than early ischaemia. Thus in the first 2 months after myocardial infarction transient ischaemia became increasingly common and more closely associated with increased myocardial oxygen demand. Because transient ischaemic episodes during early and late ambulatory monitoring have dissimilar characteristics they may also have different pathophysiologies and prognostic implications.