烧伤患者血清心肌钙蛋白T变化的临床意义

目的　评估血清心肌钙蛋白T(cardiactroponinTcTnT)对烧伤患者心肌损伤的诊断价值。　方法　 6 2例烧伤患者按伤情分为轻中度、重度和特重度 3组 ,于伤后 1、3、7、14d用放免法分别测定血清cTnT和肌酸磷酸激酶同功酶 (CK -MB) ,同期进行超声心动图和心电图检查并与 2 0例正常人员对照。　结果　 (1)与正常组比较 ,重度和特重度各时相点的cTnT均显著升高 (P <0 0 1) ,最高值可达 6 0倍 ,而且升高幅度与伤情相一致。 (2 )CK -MB的变化与cTnT大致相似 ,其最大值只有正常对的 6倍。 (3)特重度组中 9例、5例患者超声心动图和心电图表现异常。　结论　cTnT与CK -MB的动态变化均能较好反映烧伤患者的心肌损伤程度 ,cTnT的特异性和敏感性更高 ,因而更为可靠

The clinical significance of the dynamic change in serum cardiac troponin T in burned patients

OBJECTIVE: To evaluate the diagnostic value of serum cardiac troponin T (cTnT) in myocardial injury in burned patients. METHODS: Sixty-two burned patients were cardiac divided into 3 groups, i.e. mild and moderate (M, n = 25), severe (S, n = 22) and extra (E, n = 15) groups on the basis of patients' severity. Radio immunoassay was adopted to detect serum cTnT and CK-MB in patients of all groups on 1, 3, 7 and 14 postburn day. Ultrasound cardiogram and ECG (electrocardiogram) were employed to monitor cardiac function. Twenty healthy volunteers were enrolled in the control group (C). RESULTS: (1). The serum cTnT levels at all time points in patients in S and E groups were evidently higher than those in C group (P < 0.01) and paralleled very well with the severity of the patients' injuries. (2). CK-MB exhibited similar change as that of cTnT. (3). There exhibited abnormal findings with ultrasound cardiogram and ECG in five cases in E group. CONCLUSION: The dynamic changes in serum cTnT and CK -- MB could well reflect the degree of the myocardial injury in burned patients, and cTnT was much more reliable as an index of myocardial injury than the serum enzymes due to its higher specificity and sensitivity.