心脏移植患者围手术期心肌肌钙蛋白Ⅰ的动态变化

目的观察心脏移植患者围手术期心肌肌钙蛋白Ⅰ(CTn Ⅰ)的动态变化,了解心脏移植中心肌保护的效果及术后心脏损伤恢复的情况.方法测定5例心脏移植患者术前、手术当日及术后(1～17)天心肌肌钙蛋白Ⅰ的变化.供心植入前采用St.Thomas液保护,植入中用冷血保护.结果心脏移植患者与供者术前CTn Ⅰ基本在正常范围,手术当日及术后CTn Ⅰ较术前升高,然后逐渐下降,于第12天恢复在正常值范围内.第2例患者停机后对鱼精蛋白过敏又二次转流,术后CTn Ⅰ较其他4例患者峰值高且下降速度慢,于术后第21天死于脏器衰竭,另4例患痊愈出院.结论心肌肌钙蛋白Ⅰ在心脏移植当日及术后明显高正常值,术后第12天基本正常水平.心肌肌钙蛋白Ⅰ明显升高也表明供心的心肌保护仍存在着缺陷.

Dynamic change of cardiac troponin Ⅰ for heart transplantation in perioperative period

Objective: To observe the dynamic change of cardiac troponin I (CTn Ⅰ ) of heart transplantation patients in perioperative period, and to understand the effect of myocardial preservation for heart transplantation and the recovery of the heart being operated on. Methods: The cardiac troponin Ⅰ of five patients with heart transplantation was measured the day before operation, on the operating day and fron the first day to the 17th day after operation. The donor heart was preserved in St. Thomas before transplantation and in cold blood whiling transplanting. Results: The CTn Ⅰ was basically in normal scope before operation. On the transplanting day and after the transplantation, the CTn Ⅰ increased and then gradually decreased and it turned to normal on the 12th day after the transplantation. The second patient had allergy reflect and took second perfusion after the machine was stopped, after operation the CTn Ⅰ peak value was higher than the other fot r patients and the CTn Ⅰ deceased slowly and died of multi-organ failure 21 days after transplantation and other 4 patients left hospital after recovery. Conclusions: The CTn Ⅰ value was obviously higher on the transplanting day and after the day than the day before operation and it turned to normal on the 12th day after transplantation. This shows that the preservation of the donor heart has some defects.