高强度聚焦超声治疗靠近心脏肝癌后心肌酶谱和肌钙蛋白Ⅰ的变化

目的 探讨高强度聚焦超声(HIFU)治疗靠近心脏肝癌对心脏的影响.方法 分别于HIFU治疗前和HIFU治疗后1、3、7 d检测34例靠近心脏肝癌患者外周血谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)、乳酸脱氢酶(LDH)、肌红蛋白(Myo)和肌钙蛋白I(cTnI),同时监测心电图.结果 AST、CK、CK-MB、α-HBDH、LDH、Myo HIFU后1 d明显升高,差异有统计学意义(P<0.05);HIFU后3 d、7 d明显下降,与HIFU前比较,差异均无统计学意义(P>0.05).HIFU前后cTnI和心电图均正常.结论 HIFU治疗靠近心脏肝癌对心肌无明显损伤.cTnI是评价HIFU对心肌损伤的重要特异性指标.

The changes of myocardial enzymes and troponin I in patients with hepatocellular carcinoma closed to heart after high intensity focused ultrasound ablation

Objective To investigate the influences of heart in patients with hepatocellular carcinoma closed to heart after high intensity focused ultrasound ablation(HIFU). Methods Thirty four patients with hepatocellular carcinoma closed to heart received detecting the values of periphery blood aspartate transarninase(AST), creatine kinase (CK), CK-MB, α-hydroxybutyrate dehydrogenase (α-HBDH), lactate dehydrogenase(LDH), myoglobin(Myo) and troponin I (cTnI) before and 1,3, 7 days after HIFU respectively. ECG was monitored in all patients simultaneously. Results The values of AST,CK,CK-MB,α-HBDH, LDH and Myo increased 1 day after HIFU significantly (P<0.05), which decreased greatly 3 days after HIFU and nearly recovered well (P>0.05) 7 days after HIFU. However, the value of cTnI and ECG were normal before and after HIFU. Conclusions No obvious myocardium injury was found after HIFU in patients with hepatocellular carcinoma dosed to heart, cTnI may be an important marker to evaluate myocardium injury after HIFU.