烧伤患者血清心肌钙蛋白T检测的临床意义

目的：评价血清心肌钙蛋白T（cTnT)检测对烧伤患者心肌损伤的诊断价值。方法：105例烧伤患者中，中度烧伤组38例，重度烧伤组35例和电烧伤组32例，于伤后测定血清cTnT、肌酸激酶（CK）及其同功酶（CK－MB）水平，并与20例正常对照组，20例急性心肌梗死组比较。结果：（1）重度烧伤组和电烧伤组的cTnT峰值水平显著高于中度烧伤组和正常对照组（P＜0．05）。（2）重度烧伤组及电烧伤组CK升幅高于心梗组（P＜0．05）；CK－MB水平无显著差异，cTnT水平却低于心梗组（P＜0．01），临床症状及心电图检查未显示心脏损伤达到心肌梗死的程度。中度烧伤组的CK和CK－MB活性均高于正常对照组（P＜0．05），低于心梗组（P＜0．05），cTnT水平正常。结论：烧伤后测定血清cTnT可用于判断心肌损伤及其损伤程度，特异性高于血清酶学指标。

The Clinical Significance of Measurement of Serum Cardiac Troponin T in Burned Patients

Objective: To evaluate the diagnostic value of serum cardiac troponin T (cTnT) in myocardial injury in burned patients. Methods: One hundred and five burned patients were divided into three groups which included moderate (n = 38), severe (n = 35), and electric burn (n = 32) groups. ELISA was adopted to detect serum cTnT. Kinetic assay was used to detect CK and CK-MB in all patients after injury. The results were compared with myocardial obstruct group (n= 20) and healthy control group (n = 20). Results: The serum cTnT levels in severe and electric bum groups were significantly higher than that in moderate burn group and healthy control group ( P < 0.05 ). Serum cTnT level in electric burn group was higher than that in severe burn group (P < 0.05). The levels of CK in severe burn and electric burn groups were higher than that in myocardial obstruct group, the levels of cTnT were significantly lower than that in myocardial obstruct group (P<0.01) , but clinical symptom and examination of electrocardiogram did not show myocardial injury arriving the degree of myocardial obstruct in burned patients. The levels of CK and CK-MB in moderate burn group were higher than those in healthy control group (P<0.05), and lower than that in myocardial obstruct group (P<0.05). Conclusion: Serum cTnT can be used for the diagnosis of myocardial injury and well reflects the degree of injury in burned patients, and its specificity is higher than the index of serum enzymes.