摘要
目的探讨经导管室间隔缺损(VSD)封堵术治疗前后心脏血清标记物及心电图的变化及关系。方法检测VSD患者介入治疗前后血清肌钙蛋白I(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、超敏C反应蛋白(hs-CRP)的含量变化,并分别记录手术前后心电图(ECG),对治疗前后资料进行对比分析。结果介入治疗后6hVSD患者较治疗前血清cTnI明显升高(t=12.796,P<0.01),24h已下降,但仍有统计学意义(t=44.444,P<0.01),术后48h已恢复至术前水平,hs-CRP术后6h、24h、48h逐渐升高,且升高明显(t6h=55.463,t24h=111.558,t48h=109.831,P值均<0.05),血清CK、CK-MB、LDH、AST水平无明显变化。部分ECG术后较术前出现新发传导阻滞,多见于膜周部室间隔缺损病例,但与心肌酶、C反应蛋白变化无明显关系。结论经导管VSD封堵术对患者cTnI、hs-CRP及ECG有一定影响,但cTnI、hs-CRP的变化与ECG的变化关联度不大。
Objective To study the changes and relationships of serum myocardial markers and ECG before and after transcatheter closure of ventricular septal defect（VSD）.Methods Cardiac Troponin I（cTnI）,creatine kinase（CK）,creatine kinase isozyme MB（CK-MB）,lactate dehydrogenase（LDH）,aspartate aminotransferase（AST）,high sensitive C-reactive protein（hs-CRP）were tested before and after transcatheter closure of VSD.ECG changes were also recorded.The data above were analyzed.Results Serum cTnI level increased significantly at 6 hours after intervention compared to baseline（t=12.796,P0.01）,then it decreased at 24 hours,but there was still a statistical significance（t=44.444,P0.01）.At 48 hours it had restored to the preoperative level.Hs-CRP level increased gradually at 6 hours,24 hours,48 hours,and the increase was significant（t6h=55.463,t24h =111.558,t48h=109.831,P6h0.05,P24h0.05,P48h0.05）.Serum CK,CK-MB,LDH,AST levels had no significant changes.Part of the patients showed newly developed conduction block on electrocardiogram,which was more common in cases of perimembranous VSD,but there was no significant relationship between ECG and changes of the enzymes and C-reactive protein.Conclusion Transcatheter closure of VSD has certain influence on levels of cTnI,C-reactive protein and ECG,but change of cTnI,hs-CRP level had weak correlation with that of ECG.
出处
《中国介入心脏病学杂志》
2011年第2期100-103,共4页
Chinese Journal of Interventional Cardiology
关键词
心肌
生物学标记
肌钙蛋白I
C反应蛋白
心电描记术
室间隔缺损
心脏导管插入术
Myocardium
Biological markers
Troponin I
C-reactive protein
Electrocardiography
Heart septal defect
ventricular
Heart catheterization
