【摘要】 目的:评价血清肌钙蛋白T定量测定对心肌微小损伤患者的应用价值。方法:实验于2001-06/2002-05在哈尔滨医科大学附属第一临床医学院实验诊断教研室完成。收集近半年入院接受射频导管消融患者39例,男23例,女16例,平均年龄(34±13)岁,近1个月内有心肌缺血发生或近日内接受过电复率治疗的患者排除在外,糖尿病患者排除在外;正常健康体检者30例,平均年龄(29±18)岁;心肌炎患者20例,平均年龄(10±6)岁,其中男9例,女11例,全部病例均以临床检查结合动态心电图、心脏X射线正位像、心脏彩超和检测磷酸肌酸激酶同工酶等心肌酶为依据,诊断标准按1999年昆明会议修订的标准确诊的;疑似心肌炎患者240例,平均年龄(10±8)岁,其中男110例,女130例,疑似心肌炎按1994年威海会议修订的标准选择;其中39例接受射频导管消融患者插入静脉鞘管后而在插入电极导管前采静脉血做基础值血样本和术后12h采静脉血,其它各组研究对象分别空腹采静脉血2.0mL,所有标本用于磷酸肌酸激酶同工酶和血清肌钙蛋白T测定。结果:20例心肌炎患者血清肌钙蛋白T的变化为(0.190±0.177)μg/L,血清肌钙蛋白T超过参考值的有15例,占75%,磷酸肌酸激酶同工酶为(109.355±66.187)nkat/L,其中有5例磷酸肌酸激酶同工酶超过参考值,占25%,血清肌钙蛋白T升高的百分数与更多还原

【Abstract】 AIM:To evaluate the application value of serum cardiac Troponin T(cTnT) quantitative determination on minor myocardial injury. METHODS:The experiment was completed in the Department of Laboratory Diagnosis,First Clinical Medical College of Harbin Medical University from June 2001 to May 2002. Totally 39 patients(23 males and 16 females) with the average age of(34±13) years old,who undertaken radiofrequency catheter ablation(RFCA) in the recent half year,were studied,those,who occurred myocardial ischemia in past 1 month,or received treatment of electrical cardioversion recently, and the diabetic patients were excluded.Thirty healthy subjects with the average age of (29±18) years old, who underwent physical examination, and 20 cases (9 males and 11 females) of myocarditis with the average age of (10±6) years old were involved in the study.All the patients were diagnosed by clinical examination combined with dynamic electrocardiogram (ECG), heart front x-ray imaging,cardiac color ultrasonography and detection of cardiac enzyme such as MB isoenzyme of creatine kinase (CK-MB).The diagnostic standard was according to that revised on Kunming conference in 1999. A total of 240 patients (110 males and 130 females) with suspect myocarditis[the average age of (10±8) years old]were chosen according to the revised criteria in Weihai meeting in 1994.Venous blood samples of 39 patients underwent RFCA were collected before and 12 hours after the operation.2.0 mL fasting venous blood of subjects in other groups were collected, and all the samples were colleted for the measurements of CK-MB and cTnT. RESULTS:Among the 20 patients with myocarditis, the change of cTnT was(0.190±0.177) μg/L,and the level of cTnT exceeded the reference value in 15 cases(75%);CK-MB was(109.355±66.187) nkat/L, and the level of CK-MB exceeded the reference level in 5 cases(25%),there was significant difference in the rising percentage between cTnT and CK-MB(P< 0.05).Among the 39 patients, there was significant difference in the change of cTnT level before and 12 hours after RFCA[(0.010 ±0.003),(0.290±0.020) μg/L](P< 0.05);while insignificant difference was observed in the change of CK-MB activity[(88.684±47.009),(121.358±66.180) nkat/L] (P >0.05). CONCLUSION:cTnT is a index to reflect the sensitivity and specialty of minor myocardial injury.更多还原