糖原磷酸化酶BB在心脏直视手术后心肌损伤中的判定价值

摘要

目的:探讨糖原磷酸化酶BB对心脏直视手术后心肌损伤的判定价值.方法:108例行心脏瓣膜置换手术患者,分别于围术期多个时点取桡动脉血,测定血清糖原磷酸化酶BB、心肌肌钙蛋白I(cTnI)、肌酸磷酸激酶同工酶(CKMB)的水平,并检测心肌细胞凋亡程度.结果:血清糖原磷酸化酶BB于体外循环主动脉开放后最早达峰值,其峰值与cTnI、CK-MB的峰值及主动脉阻断时间呈正相关.糖原磷酸化酶BB浓度变化与caspase-3阳性面积比变化呈正比.结论:糖原磷酸化酶BB对于围术期心肌损伤的早期诊断价值优于cTnI、CK-MB,糖原磷酸化酶BB浓度越高,心肌损伤越严重；糖原磷酸化酶BB对预后及心肌保护效果的评价具有重要的价值.%Objective: To evaluate the clinical value of Glycogen phosphorylase isoenzyme BB (GPBB)in the diagnosis of myocardial damage after open heart surgery. Methods: Thirty-six patients received open heart surgery under extracorporeal circulation. The radial arterial blood samples were collected serially after unclamping the aorta to endure plasma levels of Glycogen phosphorylase isoenzyme BB. Creatine kinase- MB( CKMB) and cardiac troponin I ( cTnl). Results: Plasma Glycogen phosphorylase isoenzyme BB levels peaked earliest after reperfusion. In addition, The maximum plasma GPBB level was predictable immediately after reperfusion. The maximum plasma GPBB level correlated with the maximum plasma CKMB or cTnl level, as well as with the aortic cross-clamp time. Conclusion; Measurements of GPBB allow for earlier evaluation of myocardial damage under CPB than CKMB and cTnl. Moreover, as indicators for reflecting the myocardial damage, the sensitivity of GPBB are more valuable than CKMB and cTnl.