体外循环心脏手术中血清CK,CK-MB,LDH,cTnT值的监测及意义

[目的]通过检测体外循环心脏手术病人血清CK,CK-MB,LDH,cTnT值,判断心肌细胞的损伤程度.[方法]选择30例先天性心脏病手术及30例心脏瓣膜置换术患者,分别于停机时及术后2,24,48,70 h取静脉血测定CK,CK-MB,LDH值;选择6例冠状动脉搭桥术、15例心脏瓣膜置换术及15例先天性心脏病手术患者,分别于术前、停机及术后5,24,48 h时取静脉血检测cTnT值.[结果]随着主动脉阻断时间的延长,患者血清CK,CK-MB,LDH值呈进行性升高;心脏停跳液用量不相同,血清CK,CK-MB,LDH,cTnT值亦不相同;术中发生代谢性酸中毒者血清CK,CK-MB,LDH,cTnT值明显高于未发生者.[结论]体外循环下心脏手术患者血清CK,CK-MB,LDH,cTnT值的变化可反映心肌细胞的损伤程度.

Detection and its significant of the value of serum CK,CK-MB,LDH and cTnT at open heart operation

OBJECTIVE To assess the degree of myocardial cell injury by detecting the creatine kinase(CK),creatine kinase MB(CK-MB),lactate dehydrogenase(LDH) and serum cardial troponin T(cTnT) at open heart operation.METHODSThe venous blood was taken to measure CK,CK MB,and LDH at stopping pump and 2,24,48 and 70h after operation for 30 patients with congenital heart disease(CHD) and 30 patients with valve disease.The cTnT in 6 cases of coronary artery disease,15 cases of valve disease and 15 cases of CHD was measured at preoperation,stopping pump,and 5,24 and 48h after operation.RESULTSThe concentration of CK,CK MB and LDH rose continuously as the time of aortic clamp prolonged.The concentration of CK,CK-MB,LDH and cTnT was different as the usage of cardiac stopping fluid was different.CONCLUSIONThe concentration change of CK,CK-MB,LDH and cTnT at open heart operation.can reflect the degree of myocardial cell injury.