心肌肌钙蛋白T和心肌酶谱变化与心肌损伤的关系及临床意义

目的 :探讨血清心肌肌钙蛋白 T（c Tn T）和心肌酶谱在心肌损伤前后含量的变化与其临床意义。方法 :动态观察 2 0例二尖瓣瓣膜置换术 （MVR）患者手术前、手术后 2 h及 2 4h血清 c Tn T和心肌酶谱变化。另制备家兔心肌损伤模型 ,检测动物模型伤前和伤后 4,8,2 4h血清 c Tn T的变化特点。结果 :二尖瓣瓣膜置换术患者血清 c Tn T含量、心肌酶谱活性在术后 2 ,2 4h较术前显著升高 （P<0 .0 1） ,其中血清 c Tn T含量术后 2 h增加倍数高于其他指标。家兔心肌损伤模型伤后 4,8,2 4h血清 c Tn T含量较伤前升高非常显著 （P<0 .0 1）。结果 ;血清 c Tn T含量及心肌酶谱活性均对心肌损伤的诊断有意义 ,c Tn T的心肌特异性及早期灵敏度更高

The clinical significance of changes in serum cardiac troponin T and myocardial enzyme spectrum in myocardial injury

AIM:To evaluate the clinical signifcance of changes in serum cardiac troponin T(cTnT) and myocardial enzyme spectrum in myocardial injury. METHODS:In twenty patients who underwent mitral valve replacement(MVR),serum cTnT and myocardial enzyme spectrum levels were measured before the operation and 2 and 24 hours after the operation. Rabbit myocardial injury model was established to detect the changes of serum cTnT before the operation and 4,8 and 24 hours after the operation.RESULTS:Compared with patients before MVR operation ,the serum cTnT and the myocardial enzyme spectrum levels at 2 and 24 hours after MVR operation increased significantly (*"P*"<0.01), and the serum cTnT concentrations at 2 hours after the operation increased times more than other indexes. In rabbit myocardial injury models, the serum cTnT concentrations at 4.8 and 24 hours after injury were significantly higher than those before the injury (*"P*"<0.01). CONCLUSION:Both the serum cTnT the myocardial enzyme spectrum levels could serve as useful markers to reflect myocardial injury,but cTnT appears to be more specific and sensitive than the myocardial enzyme spectrum.