心肌酶和 cTnI 对急性一氧化碳中毒后心肌损伤的诊断价值

摘要

目的：评估肌酸激酶（creatine kinase，CK）、肌酸激酶同工酶（creatine kinase isoenzyme，CK-MB）和肌钙蛋白（cardiac troponin，cTnI）对急性一氧化碳中毒（acute carbon monoxide poisoning，ACOP）心肌损伤的诊断价值。方法：选取急性ACOP 患者66例设为 ACOP 组，健康体检者39例作为对照组。比较两组血清 CK、CK-MB 及 cTnI 水平。同时比较 ACOP 轻度中毒、中度中毒和重度中毒3组患者血清上述3指标值。结果：ACOP 组 CK、CK-MB、cTnI 水平均显著高于对照组，差异均有统计学意义（P ＜0．01）。轻度中毒组 cTnI 水平高于对照组，差异有统计学意义（P ＜0．01）；中、重度中毒组 CK、CK-MB、cTnI水平均高于对照组及轻度中毒组，差异均有统计学意义（P ＜0．01）；重度中毒组 CK-MB、cTnI 水平高于中度重度组，差异有统计学意义（P ＜0．01）。结论：cTnI 对 ACOP 后心肌损伤的诊断价值明显优于 CK、CK-MB，为判断 ACOP 患者心肌损伤程度、评估病情的重要指标。%Objective:To evaluate the diagnostic values of creatine kinase (CK),creatine kinase isoenzyme (CK-MB)and cardiac troponin (cTnI)in myocardial injury after acute carbon monoxide poisoning (ACOP).Methods:A total of 66 ACOP patients and 39 healthy people undergoing physical examination served as ACOP group and control group,respectively.Levels of serum CK, CK -MB and cTnI were compared between two groups.Meanwhile,the levels of above 3 indexes were also compared among mild, moderate and severe poisoning groups.Results:ACOP group was evidently higher in CK,CK-MB and cTnI levels than control group, and the differences were significant (P <0.01 ).Mild poisoning group was markedly higher than control group in cTnI level (P <0.01 );moderate and severe poisoning groups were prominently higher in CK,CK-MB and cTnI levels than control group and mild poi-soning group (P <0.01 );and severe poisoning group was obviously higher in CK-MB and cTnI levels than moderate poisoning group, and there was significant difference (P <0.01 ).Conclusion:cTnI is superior to CK and CK-MB in the diagnosis of myocardial injury after ACOP,and is an important index for the diagnosis of myocardial injury severity and evaluation of disease conditions in ACOP pa-tients.