心肌钙蛋白I与急性脑梗死患者心肌损害及预后关系的研究

目的通过检测心肌钙蛋白I及心电图（ECG），评定急性脑梗死患者并发心肌损伤程度及其与预后的关系。方法选取80例急性脑梗死患者，应用化学发光法检测入院即刻血清cTnI、24h血清cTnI，根据检测结果分为cTnI正常组（61例）与cTnI升高组（19例），入院即刻及24h行18导心电图检查；入院时NIHSS评分和第14、60天改良Rank’s评分，记录60d内临床死亡终点事件。结果第60天两组改良Rank’s评分比较差异有统计学意义（P〈0．05）；血清cTnI升高组心电图异常率100％，cTnI正常组心电图异常率50．82％，差异有统计学意义（P〈0．05），且心电图缺血样改变的比率cTnI升高组显著高于cTnI正常组（P〈0．05）；第60d血清cTnI升高组的病死率（36．84％）高于cTnI正常组（8．20％）（P〈0．05）。结论急性脑梗死伴发cTnI升高的发生率较高，心肌钙蛋白I升高与急性脑梗死患者的预后密切相关，急性脑梗死伴发心肌损伤是预后不良的重要因素。

Correlation of Cardiac Troponin I with Myocardial Damage and Prognosis in the Patients of Acute Cerebral Infarction

Objective To assess the severity of myocardial damage complicated in acute cerebral infarction in the patients and the correlation with the prognosis via the detection of cardiac troponin I（cTnI） and ECG. Methods Eighty cases of acute cerebral infarction were selected. The chemiluminescence method was used to detect the immediate serum cTnI on admission and 24 h serum cTnl. According to the detection results, a cTnI normal group （61 cases） and a cTnI increase group （ 19 cases） were divided. The 18 - lead ECG was tested on admission and in 24 h after admission. NIHSS score on admission and the modified Rank＇s score on the 14th and 60th days after admission, as well as clinical death outcome event in 60 days were recor ded. Results The modified Rank＇s score on the 60th day was different significantly between the two groups （ P 〈 0.05 ）. The ECG abnormality rate was 100% in the eTnI increase group and was 50.82% in the eTnI normal group, indicating the significant difference in comparison（ P 〈 0.05 ）. The percentage of ECG isehemie change in the cTnI increase group was higher significantly than that in the cTnI normal group （ P 〈 0.05 ）. The mortality （36.84%）in the eTnl increase group on the 60th day was higher than that（ 8.20% ）in the cTnI normal group（P 〈 0.05 ）. Conclusion The incidence of cTnI increase complicated with acute cerebral in farction is quite high. The cTnI increase is closely related with the prognosis in the patients of acute cerebral infarction. Acute cerebral infarction complicated with myocardial damage is the important factor of unfavorable prognosis.