非心脏手术围术期与心肌梗死急性期心肌酶谱和肌钙蛋白I比较.pdfVIP

764 Clinical Medical Journal of China．20()7．Vo1．14，No．6 中国临床医学 2007年12月 第14卷 第6期 论著 非心脏手术围术期与心肌梗死急性期心肌酶谱 和肌钙蛋白I比较 卫 宇 江 伟 王爱忠 摘要 目的：初步探讨围术期心肌缺血性疾病的诊断标准。方法：选择 3()例非心脏手术的老年患者(A纽)，测定其术前、术 中、术毕和术后第1、!天的心肌酶谱和肌钙蛋白I(cTnI)的值。3()例经冠脉造影术(CAG)证实无冠脉病变的老年患者(B 纽)，记录其PCI术前的心肌酶谱和cTnI的值。3()例心内科急性心梗(AMI)老年患者(C组)，测定其起病当天，起病后第 1、2 天的心肌酶谱和 cTnI的值。结果：非心脏手术围术期除术前外，其余时间点的心肌酶谱与B组比较，均有显著差异 (P％0．05)；与C组比较．除CK外心肌酶谱各指标均未达到C纽的标准。而非心脏手术围术期的cTnI与B组比较无显著差 异(P0．05)．但与c纽比较差异显著(P()．05)。结论：cTnI是围术期心肌缺血性疾病的特异性指标。 关键词 非心脏手术； 围术期； 心肌酶谱； 肌钙蛋白I 中图分类号 R541．4 文献标识码 A Comparison of Cardiac Enzymes and eTnI in Noncardiac Perioperative period and AMI period WEJ Y j lANG wei WA G Anzhong Department O}Anesthesiology，the Sixth People一8 Hospital，Shanghai Jiaotong University．Shanghai 200233 Abstract 0bjective：To preliminarily study the diagnosis standard of noncardiac perioperative ischemic diseases．Methods：The values of cardiac enzymes and cTnI of thirty older patients(age≥60 years)for noncardiac operations under general anaesthesia who were determined Oll the day before operation。intraoperative period．postoperative()．24，48 h(Group A)were recorded， and the values of those before coronary angiography(CAG)of thirty older patients scheduled for no main coronary artery disea— ses demonstrated by PCI(Group B)and those of thirty older patients scheduled for acute my cardial in farction(AMI)on first， second，third day of AMI(Group C)also were recorded．Results：Every cardiac enzyme during noncardiac perioperations changed obviously．compared with Group B (P0．05)，while all the cardiac enzymes except CK did not reach the level of Group C．cTnI of G-roup A had no difference with that of Group B (P0．05)，but had remarkable difference with that of Group C (PO．05)．Conclusion：cTnI is an specific marker in diagnosis of peroperartive ischemic diseases．