肌钙蛋白I在心脏瓣膜病患者术前与术后浓度变化及其临床意义

目的 探讨血清肌钙蛋白I (cTnI)在心脏瓣膜病患者术前、后浓度变化及其对判定心肌损伤程度和预后的临床意义.方法 通过对近2年来心胸外科76例心脏瓣膜病患者(合并冠心病者除外)手术前(入院时及术前1 d)与术后(心脏复跳后2 h、复跳后12 h、术后第7天)血清cTnI的浓度测定,分析其心肌损伤程度、修复及预后.cTnI >0.5 ng/mL为阳性.结果 76例心脏瓣膜病患者中,82.89%的患者入院时血清cTnI>0.5 ng/mL,其中76.32%的患者血清cTnI≥5 ng/mL;78.95%的患者术前1 d血清cTnI>0.5 ng/mL,其中60.53%的患者血清cTnI≥5 ng/mL;所有患者心脏复跳后2 h其血清cTnI≥5 ng/mL;96.05%的患者心脏复跳后12 h血清cTnI>0.5 ng/mL,其中85.53%的患者血清cTnI浓度高于正常高值10倍;74例患者中(有2例因低心排血量综合征死于术后24 h),90.54%的患者术后第7天血清cTnI>0.5 ng/mL,其中79.73%的患者血清cTnI≥5 ng/mL.结论 cTnI是高度特异、高度灵敏的反映心肌细胞损伤和坏死的标志物,其存在着长时间的诊断窗口,为临床判断患者心肌细胞损伤的修复提供可靠依据.

The concentration change and clinic significance of Troponin I in patients suffered with heart valve disease before and after operation

Objective To investigate the concentration change of Troponin I(cTnI) in patients suffered with heart valve disease before and after operation and the clinic significance for the detection of the degree of myocardial damage and prognosis.Methods The concentration of cTnI in 76 sufferers with heart valve disease two years later was detected at the different period.Results In all sufferers,there were 82.89% sufferers whose cTnI concentration were higher than normal,and 76.32% sufferers higher than ten times when first day in the hospital.There were 78.95% sufferers whose cTnI concentration were higher than normal,and 60.53% sufferers higher than ten times when one day before operation.The cTnI concentration of all sufferers were higher than ten times when two hours after operation.There were 96.05% of sufferers whose cTnI concentration were higher than normal,and 85.53% sufferers higher than ten times when twelve hours after operation.There were 90.54% sufferers whose cTnI concentration higher than normal,and 79.73% sufferers higher than ten times when selven days after operation.Conclusion cTnI is a hige differential and sensitive sign for reflecting myocardial damage,with longer diagnosis period.It offers credible evidence of restore of myocardial.