摘要
目的分析严重急性呼吸综合征(SARS)患者心肌酶的变化特点。方法用常规方法,检测84例(9例死亡,8例插管,30例无创通气,37例无辅助通气)SARS患者的心肌酶指标。结果SARS患者发病3～6d起,心肌酶开始上升,但上升的幅度差异很大。18例(21.4%)SARS患者,整个病程血清心肌酶均在正常参考范围。α-HBDH、AST、LDH、LD-1、CK和CK-MB的异常率分别为60.7%、53.6%、77.4%、44.0%、38.1%和28.4%。SARS患者心肌酶随病情变化而改变,病情越重,升幅越大,异常率越高,死亡组和插管组患者心肌酶平均峰值和异常率明显高于无创通气组(P<0.001),无创通气组患者又明显高于无辅助通气组(P<0.001)。除死亡组外,多数患者心肌酶在4周内恢复正常。结论大部分SARS患者心肌酶异常,部分出现心肌损害,临床上应予足够的重视。
Objective To study the changes of serum myocardial enzymes in the SARS patients and its clinical significance. Methods The serum myocardial enzymes, α hydroxybutyric acid dehydrogenase(α HBDH), aspartate aminotransferase(AST), lactate dehydrogenase(LDH) and isoenzyme(LD 1), creatinine kinase(CK) and isoenzyme(CK MB), were determined in 84 serum samples of the SARS patients by HITACHI7170A automatic biochemistry analyzer. Results The levels of the serum myocardial enzymes began to elevate in 3 to 6 days after SARS onset. The range of variation was quite different. Myocardial enzyme activity of 18 cases was always in normal limits. The abnormality rates of α HBDH, AST, LDH, LD 1, CK and CK MB were 60.7%, 53.6%, 77.4%, 44.0%, 38.1% and 28.4%, respectively. Myocardial enzymes varied with the situation of SARS patients and returned to normal limits in most of the cases within 4 weeks except in the death group. The abnormality rate and average peak value of myocardial enzymes both in death group and intubation group were significantly higher than those in non invasive ventilation group(P< 0.001), and was remarkably higher in the non invasive ventilation group than those in non aided ventilation group(P< 0.001). Conclusions Myocardial enzymes are positively correlated with the situation of SARS patients. Myocardial enzymes examination could be used as a clinical marker for surveillance of myocardial injury and hypoxia.
出处
《热带医学杂志》
CAS
2004年第2期139-141,209,共4页
Journal of Tropical Medicine
