摘要
目的评价天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)、肌酸肌酶(CK)、肌酸肌酶同工酶(CK-MB)及血肌钙蛋白(cTnI)、肌红蛋白(Myo)在急性PTE继发心肌损害中的临床意义。方法对三间医院近5年来影像学确诊的36例PTE住院患者,采用免疫化学发光法及速率酶学法分别测定血清Myo、cTnI、CK-MB、AST、LDH、HBDH、CK水平,以同期住院非PTE、无缺氧及合并心、肝、肾疾病者为心肌生物标记物基线值组。并与肺栓塞面积、肺动脉高压、死亡率进行相关分析。结果患者心肌生物标记物升高:AST(56.14±15.73)U/L,LDH(303.06±94.99)U/L,HBDH(234.67±87.86)U/L,CK-MB(26.19±12.39)U/L,CK(129.25±76.14)U/L,Myo(70.63±45.75)ng/ml,cTnI(0.45±0.41)ng/ml,与基线组比较有显著性差异(P<0.01)。AST、CK-MB与死亡显著相关;cTnI与肺动脉高压相关;Myo与肺动脉高压和大面积肺栓塞相关。结论心肌生物标记物AST、LDH、HBDH、CK、CK-MB、Myo、cTnI可作为诊断PTE继发心肌损害的指标。AST、CK-MB、cTnI、Myo可监测病情,作为PTE继发心肌损害预后参考指标。心肌生物标记物检测对急性肺栓塞的诊治具有一定的临床意义。
Objective To investigate the clinical value of monitoring the serum cardiac biomarkers in patients with pulmonary thromboembolism （PTE） and secondary myocardial injury. Methods The serum cardiac biomarkers including aspartate aminotransferase （AST）, lactate dehydrogenase （LDH）, α-hydroxybutyrate dehydrogenase （HBDH）, creatine kinase （CK）, creatine kinase isoenzyme （CK-MB）, cardiac tropnin I （cTnI） and myoglobin （Myo） were measured using immunochemiluminescent assays in 36 patients with PTE, who were diagnosed according to imaging findings in the recent 5 years. The measurements in concomitant non-PTE patients flee of heart, liver, or kidney diseases were used as the baseline values of the biomarkers. Correlation analysis of the measurements was conducted in relation to the pulmonary embolism area, pulmonary hypertension and mortality rate. Results The PTE patients exhibited significantly elevated levels of the serum cardiac biomarkers including AST （56.14±15.73 U/L）, LDH （303.06±94.99 U/L）, HBDH （234.67 ＋87.86 U/L）, CK-MB （26.19±12.39 U/L）, CK （129.25±76.14 U/L）, Myo （70.63±45.75 ng/ml）, and cTnI （0.45±0.41 ng/ml） in comparison with the baseline values （P〈0.01）. Of these biomarkers, AST and CK-MB showed a significant correlation to the mortality, cTul was correlated to pulmonary hypertension, and Myo was correlated to pulmonary hypertension and massive pulmonary embolism. Conclusions Measurements of these serum cardiac biomarkers may serve as indicators for diagnosis of myocardial injury secondary to PTE. AST, CK-MB, cTnI, and Myo can help assess the prognosis of the patients.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2008年第10期1853-1855,共3页
Journal of Southern Medical University
关键词
肺血栓栓塞症
心肌损害
心肌酶
肺动脉高压
pulmonary thromboembolism
myocardial injury
serum cardiac biomarkers
pulmonary hypertension
