围术期心肌肌钙蛋白I变化对老年高血压性心脏病患者的意义

①目的探讨老年高血压性心脏病惠者围术期心肌肌钙蛋白I（eTnI）的动态变化及其对判断心肌损伤程度的意义。②方法选择45例60岁以上择期手术患者．分成3组即对照组（A组）、高血压组（B组）、高血压性心脏病组（C组）。在围术期不同时段采取惠者肘部静脉血，用免疫化学发光法测定血清eTnI值；记录围术期不同时段SBP、DBP、HR和ECG中的ST-T等的变化。③结果A组cTnI围术期比较差异无显著性（P〉0．05）；B组、C组则手术30分钟后开始升高．与术前比较差异有极显著性（P〈0．01）。与A组比较差异极显著性（P〈0．01）。B组和C组比较，差异有极显著性（P〈0．01）；C组围术期ECG动态变化与A组、B组比较差异有显著性（P（0．05）。④结论老年高血压性心脏病患者麻醉手术风险明显高于老年高血压及无高血压患者．围术期测定eTnI变化具有重要临床价值。

The clinic studies on variations of cTnI in the elderly patients with hypertentive heart disease in perioperative

Objective To observe the variations of cTnI in the elderly patients with hypertentive heart disease in perioperative and to estimate cardiomuscle injuries.Methods 45 patients above 60 years old were divided into three groups,i.e.control group(group A),hypertension group(group B) and hypertensive heart disease group(group C).Blood samples were obtained in perioperative.Serum concentrations of cTnI were simultaneously measured using the chemilum inescent immunometroc assay.The variations of SBP,HR and ECG were recorded in perioperative.Results cTnI in group A was not significantly different in perioperative(P>0.05),while in group B and group C,cTnI increased gradually after 30 minutes in operation.There were significant differences compared with preanaesthesia(P<0.01).In the meantime,cTnI in group B and group C were significantly different,compared with in group A(P<0.01);cTnI in group C was significantly different compared with in group B(P<0.01).The variations of ECG in group C were significantly different compared with in group A,group B(P<0.05).Conclusion The elderly patients with hypertentive heart disease had more danger than the elderly hypertension patients and those elderly patients without hypertension.cTnI measured in perioperative had important clinic values.