血清CK-MB和cTnT水平评估先天性心脏病患儿介入治疗后心肌损伤的价值

摘要

Objective To explore the role of serum creatine kinase MB (CK‐MB)and cardiac troponin T (cTnT ) in evaluating myocardial damage after interventional therapy in children with congenital heart disease (CHD ) .Methods A total of 152 children with CHD receiving cardiac catheterization intervention closure was divided into 3 groups of ASD(secundum atrail septal defect , 49 cases) ,VSD(perimembrane ventricular septal defect ,61 cases) and PDA (patent ductus arteriosus , 42 cases) .Serum CK‐MB and cTnT were detected by immunosuppression and chemiluminescence before operation(T0) ,immediately after operation (T1) and at 48 hours after operation (T2) .Results Serum CK‐MB and cTnT of 3 groups were in normal limits at T0 .Serum levels of CK‐MB in groups of ASD and VSD were higher at T1 than those at T0(P<0 .05 or P<0 .01) .Serum level of CK‐MB in group VSD was lower at T2 than that at T1(P<0 .05) .Serum levels of cTnT in three groups were all higher at T1 than those at T0(P<0 .05 or P<0 .01) ,which at T2 were decreased(P<0 .05) ,but still higher at T2 than those at T0 in groups of VSD and PDA (P<0 .05) .Conclusion Serum levels of CK‐MB and cTnT can be used as the indicators to evaluate myocardial damage after intervention therapy in CHD children ,but serum cTnT level is more sensitive .%目的探讨血清肌酸激酶同工酶MB（CK‐MB）和心肌钙蛋白 T （cTnT ）水平评估先天性心脏病（CHD）介入治疗后心肌损伤的价值。方法接受心导管介入封堵术CHD患儿152例分为继发孔型房间隔缺损（ASD组，49例）、膜部室间隔缺损（VSD组，61例）和动脉导管未闭（PDA组， 42例）三组，免疫抑制法和化学发光法检测术前、术后即刻及术后48 h血清CK‐MB和cTnT 水平。结果三组患儿术前血清CK‐MB和cTnT 均在正常水平。ASD、VSD组术后即刻血清CK‐MB水平均升高（P＜0．05或P＜0．01）；VSD组术后48 h血清CK‐MB水平低于术后即刻（P＜0．05）。三组术后即刻血清 cT nT 水平均升高（ P＜0．05或P＜0．01）。三组术后48 h血清 cT nT 水平均下降（P＜0．05），但VSD、PDA组仍高于术前（P＜0．05）。结论检测血清CK‐MB和cTnT 两项指标均可用于评估CHD患儿介入治疗后心肌损伤，血清cTnT水平更敏感。