心肌标志物检测在慢性阻塞性肺疾病患者低氧血症中的临床意义

目的探讨心肌标志物检测在慢性阻塞性肺疾病（COPD）患者低氧血症中的临床意义。方法对96例COPD急性发作期患者同时测定动脉血氧分压（PaO2）及血清肌钙蛋白I（cTnI）、肌钙蛋白T（cTnT）和肌酸激酶同工酶质量（CK—MB mass）水平。结果COPD患者伴不同程度低氧血症，血清cTnI、cTnT和CK—MBmass水平均明显高于正常对照组（P〈0．01），且重度低氧血症组患者血清中3项心肌标志物浓度均明显高于中度低氧血症组和轻度低氧血症组，相互比较差异有统计学意义（P〈0．01）；各患者组PaO2水平与相对应的血清cTnI、cTnT和CK-MBmass水平间呈负相关（分别为r=-0．814、P〈0．01；r=-0．792、P〈0．01和r=-0．707、P〈O．05）；血清cTnI、cTnT和cK—MB mass检测的阳性率分别为82．2％、62．5％、44．8％，以cTnI的阳性率最高，与cTnT和CK—MBmass比较差异有统计学意义（分别为P〈0．05、P〈0.01）。结论COPD患者低氧血症可导致血清中心肌标志物浓度增高，且与PaO2水平呈负相关，常规检测血清中心肌标志物浓度，尤其是cTnI，对及时了解COPD患者心肌损害程度、改善疗效有重要意义。

Clinical significance of serum cardiac markers' in patients of chronic obstructive pulmonary disease with hypoxemia

Objective] To investigate the clinical significance of serum cardiac markers in patients suffering from chronic obstructive pulmonary disease (COPD) with hypoxemia. Methods] Serum troponin I(cTnI),troponin T(cTnT),creatine kinase isoenzyme mass(CK-MB mass) and press of oxygen (PaO2) were measured in 96 patients with COPD. Results] Serum cTnI,cTnT and CK-MB mass levels in the patients of COPD with various hypoxemia were higher than normal control (P <0.01). The differences between the severe group and other groups had obvious significance;PaO2 level in the COPD cases had a negative relation with serum cTnI,cTnT and CK-MB mass (r =-0.814, P <0.01; r =-0.792, P <0.01 and r =-0.707, P <0.05, respectively); Positive rate of cTnI, cTnT and CK-MB mass was 82.2%, 62.5% and 44.8% respectively. The differences between cTnI and cTnT,CK-MB mass had obvious significance (P <0.05 and P <0.01). Conclusions] Hypoxemia may significantly lead to increase of serum cardiac markers of patients with COPD, and it has a significant negative relation with PaO2 level. There is very important clinical value to master injury of myocardium in time and improve curative effect by observing concentrations of cardiac markers (especially is cTnI) in patients with COPD.