摘要
目的 :比较肌酸激酶 ( CK)、肌酸激酶同工酶 ( CK- MB)及心肌肌钙蛋白 T( c Tn T) 3项指标对射频导管消融术 ( RFCA)所致微小心肌损伤 ( MMD)的诊断价值 ,探索利用 c Tn T判断心肌损伤程度的简便方法。方法 :对30例行 RFCA的室上性心动过速患者进行了上述 3项指标的动态监测。结果 :RFCA前 ,30例患者 CK、CK- MB、c Tn T均在正常范围。 c Tn T在 RFCA后即刻显著升高 ,由 RFCA前的 ( 0 .13± 0 .0 5 ) μg/L 升至 ( 0 .5 7± 0 .47) μg/L ,4h达峰值 ( 1.10± 0 .98)μg/L ,72 h恢复至 RFCA前水平。 RFCA后即刻 c Tn T浓度平均升高达 ( 5 .2± 3.1)倍 ,明显高于 CK、CK- MB的升高倍数 ( P <0 .0 1)。 c Tn T达峰值时较 RFCA前升高 ( 11.8± 6 .5 )倍 ,明显高于CK、CK- MB的升高倍数 ( P <0 .0 1)。 c Tn T和 CK- MB于 RFCA后 4h左右达峰值 ,明显早于 CK达峰值的时间( P<0 .0 1)。 RFCA后 c Tn T升高超过界值者占 93% ,显著高于 CK、CK- MB升高超过界值者的比例 ( P<0 .0 1)。结论 :RFCA后 c Tn T达峰早 ,即刻及峰值升高倍数明显高于 CK与 CK- MB,是检测 RFCA所致 MMD的优良指标 ;RFCA所致 MMD可由动态监测得出的 c Tn
objective:To compare the value of CK,CKMB,cTnT in diagnosing minor myocardial damage (MMD) caused by radiofrequency catheter ablation (RFCA), and to explore simple and convenient method of deciding the degree of mycardial injury.Method:30 patients of supraventricular tachyarrhythmia who underwent RFCA were chosen into this study.CK,CKMB,cTnT were monitored before and after the procedure.Result: Before RFCA,CK,CKMB,cTnT were in the reference range in 30 patients of noninterfering group.cTnT level significantly elevated right after RFCA:from ( 0.13 ± 0.05 )μg/L to ( 0.57 ± 0.47 )μg/L,and to the peak concentration ( 1.10 ± 0.98 )μg/L at 4 h,then recovered to the level of preoperation at 72 h after RFCA.The concentration of cTnT rose up to ( 5.2 ± 3.1 ) times right after RFCA which was significantly higher than that of CK and CKMB(P< 0.01 ).Peak cTnT was ( 11.8 ± 6.5 ) times as high as that of preoperation which was significantly higher than that of peak CK and peak CKMB(P< 0.01 ).cTnT and CKMB rose to the peak at about 4h after RFCA,significantly earlier than that of CK (P< 0.01 ).After RFCA the percentage of cTnT rising above the cutoff was 93% which was significantly higher than that of CK and CKMB (P< 0.01 ).Conclusion:cTnT is the best marker to measure the MMD caused by RFCA.The MMD caused by RFCA can be evaluated by the peak cTnT measured from monitoring cTnT level at 2h,4h,6h after RFCA.
出处
《临床心血管病杂志》
CSCD
北大核心
2000年第5期199-202,共4页
Journal of Clinical Cardiology
关键词
射频导管消融术
心肌损伤
肌钙蛋白
肌酸激酶
Catheter ablation
radiofrequency Myocardial damage Troponin Creatine kinase
