【摘要】 目的　探讨先天性心脏病心内直视手术有关因素对心肌细胞损害程度。方法　随机选择先天性心脏病患者5 0例,于手术前后不同时间采血测定其肌酸激酶(CK) ,肌酸激酶(CK -MB) ,乳酸脱氢酶(LDH) ,肌钙蛋白T(cTnT) ,分别进行多因素组间对比。结果　1、严重创伤组与普通创伤组比较,CK、CK -MB、LDH(P <0 .0 1) ,cTnT(P <0 .0 0 1)均有显著性差异。2、主动脉阻断时间>6 0分钟与<30分钟组比较,停机时CK、CK -MB、LDH及cTnT均有显著性差异(P <0 .0 1)。3、心脏停跳液用量<10ml/kg组与>15ml/kg组比较,停机时CK、CK -MB及cTnT均有显著性差异(P <0 .0 1)。4、术中代谢性酸中毒组与无代谢性酸中毒组比较,停机时CK、CK -MB ,LDH(P <0 .0 5 ) ,cTnT(P <0 .0 1)均有显著性差异。结论　术中检测CK、CK -MB、LDH及cTnT是判断心肌损害程度的方法及手段,cTnT能准确反映心肌损害程度并优于CK、CK -MB、LDH ,它可作为心脏手术中检测心肌损害的独立指标。更多还原

【Abstract】 Objective To study extent of damage which concerned factor of congenital heart disease heart open poeration deduced to cardiac muscle cell.Methods: 50 congenital heart diseases were random selected,the CK、CK-MB、LDH and cTnT were measured at different time before and after cardiac surgery,then contrast them with each other.Results:The CK、CK-MB、LDH and cTnT increased significantly at the time of cardio-pulmonary bypass(CPB) stopping in the group of serious surgery trauma than that of common group(P<0.01).The CK、CK-MB、LDH and cTnT were higher in group of aorta clamping>60 minutes than that of <30 minutes group(P<0.01),there was significant difference for CK、CK-MB、LDH and cTnT between using cardioplega solution<10ml/Kg and >15ml/Kg(P<0.01).The CK、CK-MB、LDH and cTnT were higher in the group of metabolic acid toxicity than that of normal acid badic group(P<0.05).Conclusion:The measure of CK、CK-MB、LDH and cTnT during poeration can estimate extent of damage to cardiac muscle cell.,The cTnT can more accurately reflect the damage of cardiac muscle than CK、CK-MB and LDH,so cTnT should be looked as independent criterion which can estimate the damage of cardiac muscle.更多还原