急性肺栓塞患者血清心肌酶、心肌肌钙蛋白Ⅰ的检测及其临床意义

目的探讨血清心肌酶及心肌肌钙蛋白Ⅰ(cTnⅠ)检测在急性肺栓塞(pulmonary embolism,PE)中的应用。方法使用全自动生化分析仪、采用免疫发光法检测61例急性PE患者[大面积、次大面积急性PE(大面积、次大面积组)39例,非大面积急性PE(非大面积组)22例]cTnⅠ水平,使用全自动生化分析仪检测2组患者血清心肌酶[天门冬氨酸转氨酶(AST)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)]水平。结果大面积、次大面积组血清cTnⅠ、AST、LDH、CK、CK-MB、α-HBDH水平均显著高于非大面积组(均P<0.05)。结论急性PE常伴有心肌细胞损伤,应常规行血清心肌酶及cTnⅠ测定,血清心肌酶及cTnⅠ的测定有助于危险分层。

Detection of Serum Myocardial Enzymes and Cardiac Troponin I and Its Significance in Patients with Acute Pulmonary Embolism

Objective To investigate the application of the detection of serum myocardial enzymes and cardiac troponin I （cTn I ） in acute pulmonary embolism（PE）.Methods The serum levels of cTn I , aspartic transaminase（AST）,creatine phosphokinase （CK）,creatine phosphokinase MB isoenzyme （CK- MB）,lactate dehydrogenase（LDH）,α-hydroxybutyrate dehydrogenase （α-HBDH）were determined using automatic biochemical analyzer in 39 patients with acute massive or submassive PE （massive/ submassive group） and 22 patients with acute non-massive PE （non-massive group）. Results The levels of cTn I ,AST, LDH, CK, CK-MB and α-HBDH in massive/submassive group were significantly higher than those in non-massive group （all P〈0.05）. Conclusion Acute PE is often accompanied by myocardial cell injury. The determination of serum myocardial enzymes and cTn I may contribute to risk stratification and should be performed routinely in patients with acute PE.