摘要
目的:本研究旨在评价心型脂肪酸结合蛋白(H-FABP)能否作为体外循环下瓣膜置换术后心肌损伤的早期诊断指标。方法:对接受单瓣置换(A组)和双瓣置换(B组)手术的两组病人测定麻醉诱导后至主动脉开放后24h之间的H-FABP、心肌特异型肌钙蛋白Ⅰ(cTn-Ⅰ)和肌酸激酶同工酶MB(CK-MB)的血浆浓度变化。比较两组病例的临床资料和3种蛋白在不同时间的浓度,分析H-FABP峰值浓度与cTn-Ⅰ和CK-MB峰值浓度以及与主动脉阻断(ACC)时间和体外循环(CPB)时间的相关性。结果:主动脉开放后,3种蛋白血浆浓度很快上升,但B组始终高于A组,在峰值浓度时间点差异有显著性。H-FABP达到峰值浓度的时间明显早于cTn-Ⅰ和CK-MB,3种蛋白峰值浓度具有高度相关性且H-FABP峰值浓度与ACC时间和CPB时间具有良好的相关性。结论:心型脂肪酸结合蛋白能作为体外循环下瓣膜置换术后心肌损伤早期诊断的合适指标。
Objective To estimate the value of heart fatty acid binding protei n (H FABP) in the rapid evaluation of myocardial damage following valve replace ment surgery. Methods Thirty consecutive patients were enrolled and distributed into two groups: single valve replacement group (group A) and double valve repla cement group (group B). Blood samples were collected at 7 time points from 5 mi n after anesthesia to 24 h after aortic declamping and determined plasma levels of H FABP, cardiac troponin Ⅰ(cTn Ⅰ) and CK MB. The clinical characteristi cs of both groups and the plasma levels of three proteins at different time were compared. Pearsons correlation test was used to analyze the correlation betwe en the peak levels of H FABP with cTn I and CK MB, and the correlation betwee n the peak level of H FABP with aortic cross clamp (ACC) time and cardiopulmon ary bypass (CPB) time. Results Plasma levels of three markers elevated quickly a fter aortic declamping and kept higher in group B than in group A, while signifi cant differences were observed at the peak level. H FABP peaked significant ear lier than other two markers, and in both groups, the peak level of H FABP, cTn I and CK MB associated well and the peak level of H FABP also associated wel l with CPB time and ACC time. Conclusion The H FABP is a reliable marker in the rapid evaluation of CPB induced myocardial damage following valve replacement s urgery.
出处
《实用医学杂志》
CAS
2005年第10期1019-1022,共4页
The Journal of Practical Medicine
关键词
体外循环
心肌再灌注损伤
人工心脏瓣膜
瓣膜置换术
Extraeorporeal circulation Myocardial reperfusion injury Heart va lve prosthesis
