心内直视手术中监测血清心肌肌钙蛋白T的临床意义

采用酶联免疫法测定１５例心内直视手术患者血清心肌肌钙蛋白Ｔ（ｃＴｎＴ）及心肌酶学指标，并探讨其监测心肌损伤的价值。结果显示手术结束时所测指标均较术前明显升高（Ｐ＜０．０１）；ｃＴｎＴ值与升主动脉阻断时间有明显正相关（ｒ＝０．６０１４，Ｐ＜０．０５）；ＣＫＭＢ虽随升主动脉阻断时间延长而升高，但两者之间无显著相关性（ｒ＝０．４７１２，Ｐ＞０．０５）。提示血清ｃＴｎＴ和ＣＫＭＢ可监测心脏手术中再灌注早期心肌细胞损伤并评价心肌保护措施，ｃＴｎＴ优于ＣＫＭＢ。

Changes of serum cardiac troponin T in patients undergoing cardiac surgery

We detected the changes of serum cardiac troponin T(cTn T) content and serum cardiac enzyme activities in 15 patients with cardiopulmonary bypass during cardiac operation. The central venous blood samples were collected to measure the serum concentration of cTn T by enzyme immunoassay methods and activities of lactate dehydrogenase(LDH), creatine kinase(CK), and creatine kinase isoenzyme(CK MB) by biochemical methods. The content of cTn T and activities of LDH, CK, and CK MB increased significantly after cardiac surgery. There was positive correlation between cTn T and aortic cross clamping time ( r =0.6014, P <0.05), but there was no correlation between CK MB and aortic cross clamping time ( r =0.4712, P >0.05). We conclude that serum cTn T and CK MB can monitor cardiac ischemic reperfusion injury and can evaluate myocardial protection methods during cardiac operation, but cTn T is better than CK MB.