心脏移植患者手术前后血清中肌钙蛋白I及肌酸激酶同工酶的动态观察

目的　观察心脏移植患者手术前后血清中心肌肌钙蛋白 I(cardiactroponin,c Tn I)和肌酸激酶同工酶 (CK- MB)的动态变化 ,探讨其对心肌损伤状况判断的意义 .方法　 6例接受同种异体心脏移植患者 (在移植前及移植后不同时间取患者静脉血标本 ,检测其血清中 c Tn I和 CK- MB的水平 .结果　 6例患者中有 1例术前血清中 c Tn I和 CK- MB的浓度高于正常 ,6例患者 c Tn I和 CK- MB均在手术后当日达最高峰 ,5例患者 c Tn I在术后 (10～ 34) d下降至正常人水平 .CK- MB在术后 (11± 16 ) d下降至正常人水平 .结论　 c Tn I与 CK-MB在心脏移植前后的变化规律相似 ,但 c Tn I高于正常的时间较 CK- MB长 ;术前 c Tn I与 CK- MB正常的患者预后较好 ;c Tn I与 CK- MB升高与手术损伤及移植排斥反应有关 ,心脏移植后受者血清中 c Tn I与 CK- MB的动态变化趋势与心脏移植效果有密切联系 ;c Tn I诊断心肌损伤的敏感性高于 CK-MB.

Preliminary study on release of cardiac troponin I and creatine kinase-MB in sera of heart transplantation patients

AIM To investigate the release of cardiac tro ponin I (cTnI) and creatine kinase MB (CK MB) and their efficacy in diagnosing myocardial injury in heart transplantation patients. METHODS 200 venous blood samples from 6 heart allograft recipients were taken at different time points before and after operation. Their cTnI and CK MB concentrations were determined respectively. RESULTS cTnI and CK MB increased significantly in 1 patient before operation. cTnI and CK MB reached the peak on the first day in all patients post operation. cTnI declined to normal level on the 10~34 postoperative day, while CK MB declined to normal level on the 11~16 postoperative day. CONCLUSION The duration of cTnI and CK MB is similar in heart transplantation patients. The prognosis of patients whose cTnI and CK MB was normal before operation is better. The increased cTnI and CK MB are related to operation and graft rejection. cTnI is of larger diagnosis time window and higher sensitivity in detecting myocardial damage than CK MB.