心肌挫伤早期实验与临床诊断

目的探讨早期心肌挫伤的实验与临床诊断依据。方法收集62例闭合性胸部损伤病例，将合并心肌挫伤的29例纳入观察组，其余33例纳入对照组。比较组间肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、肌钙蛋白T（cTnT）、肌钙蛋白I（cTnI）水平差异；依据是否合并心电图或心脏超声异常进行亚组分析。结果观察组CK、CK-MB、cTnT、cTnI水平均明显高于对照组，差异有统计学意义（P均＜0.01）。存在心电图和心脏超声异常者，各心肌酶水平均高于无异常者，差异均由统计学意义（P均＜0.01）。采用等级相关分析显示，心电图和心脏超声改变与各心肌酶水平存在正相关关系（P均＜0.05）。结论心肌酶学改变可作为早期心肌挫伤的诊断依据，但需结合心电图和（或）心脏超声作为依据，进行相关鉴别诊断。

Laboratory and Clinical Diagnosis of Early Myocardial Contusion

Objective To discuss the laboratory and clinical diagnosis of early myocardial contusion （MC）. Methods We collected 62 patients with closed injury of chest. 29 cases with MC were divided into observation group （OG）, and the rest 33 cases were divided into control group （CG）. We compared the difference of CK, CK-MB, cTnT, cTnI between them. Besides that, we analysed the myocardial enzymes in each subgroup based on the changes of electrocardiogram and cardiac ultrasound. Results The CK, CK-MB, cTnT, cTnI in OG were higher than those in CG with statistical signiifcance （All P〈0.01）. The patients whose electrocardiogram and cardiac ultrasound were abnormal, had higher myocardial enzymes （All P〈0.05）. There was a positive relativity between the myocardial enzymes and the electrocardiogram or cardiac ultrasound changes （All P〈0.05）. Conclusion The changes of myocardial enzymes could help to diagnose the early MC, but it need to combine the electrocardiogram or cardiac ultrasound which could identify form other illness.