【摘要】 目的 探讨胎儿宫内窘迫对足月新生儿血清心肌酶变化的相关性分析。 方法 将2009年10月-2010年9月在我产科出生有宫内窘迫史而羊水和Apgar评分均正常的足月新生儿20例为观察组，同期出生的健康足月新生儿10例为对照组，分别测定两组出生后1、5 d血清肌酸激酶同工酶（CK-MB）及心肌肌钙蛋白I（cTnI）水平。 结果 观察组出生后1 d血清cTnI高于对照组（Plt;0.001），CK-MB两组差异无统计学意义（Pgt;0.05），出生后5 d血清CK-MB及cTnI均高于对照组（Plt;0.001）；观察组和对照组出生后5 d血清cTnI水平均较1 d时升高，差异有统计学意义（Plt;0.001），血清CK-MB浓度均低于1 d时（Plt;0.001）。观察组患儿经过治疗，1个月后复查血清cTnI除1例未恢复至正常水平外，其余血清CK-MB及心电图均恢复正常。 结论 单纯宫内窘迫可造成足月新生儿血清cTnI及CK-MB水平升高，常规检测血清cTnI及CK-MB能及时了解此类新生儿的心肌受损情况，从而尽早予以保护心肌治疗。【Abstract】 Objective To make a correlation analysis on effect of fetal distress on changes of cardiac enzyme in neonatal serum. Methods Twenty full-term newborns who met diagnostic criteria of fetal distress but were born with normal amniotic fluid and Apgar score between October 2009 and September 2010 were included in the observed group, another ten normal full-term newborns born at same period were in control group. The serum values of cardiac troponin I (cTnI) and creatine kinase (CK-MB) were collected and measured one and five days after birth. Results One day after the birth, the serum levels of cTnI was significantly higher in the observed group compared to that in the control group (Plt;0.001), but there was no difference in CK-MB between the two groups (Pgt;0.05). The values of cTnI five days after the birth were higher than those one days after the birth in both groups (Plt;0.001). The values of CK-MB were higher one day after birth than those five days after birth in both groups (Plt;0.001). In observation group after the treatment, serum cTnI in one patient did not return to normal, and the remaining neonatal serum CK-MB and ECG were normal. Conclusions Elevated level of serum cTnI and CK-mb could be caused by fetal distress in normal full-term newborns with normal amniotic fluid and Apgar score. Routine testing of serum cTnI and CK-MB may be useful to detect myocardial damage in newborns.
Myocardial stunning is the main pathological basis of heart dysfunction after open heart operation, its exact pathogenesis hasn’t been clarified until today.In recent years,the molecular and cellular studies have revealed possibly crucial pathogenesis of myocardial stunning that delayed recovery of myocardial glucose oxidation causes intracellular H + accumulation which augments H + Na + exchange thus leading to [Na +] i overload.[Na +] i overload increases Na + Ca 2+ exchange resulting in t...
目的:明确肌钙蛋白Ⅰ(cTnI)在心源性呼吸困难的鉴别诊断中有无应用价值。方法:比较急性心衰与急性肺源性呼吸困难时cTnI的变化情况,并观察一定的cTnI临界值辅助诊断心衰的敏感性和特异性。结果:总共156例患者,最后确诊为急性心衰的患者69例,而肺源性呼吸困难患者87例。急性心衰组的平均cTnI值为076±085ng/dL,而肺源性呼吸困难组为025±032ng/dL,两组间有显著性差异(Plt;0001)。根据ROC曲线计算肌钙蛋白Ⅰ的临界值(截点值)为042ng/dL,其鉴别心衰的敏感度为7153%,特异度为9036%,准确度为8014%。结论:检测肌钙蛋白Ⅰ水平并与其它临床信息相结合,有助于快速准确地诊断充血性心力衰竭。
Objective To investigate the changes of serum cardiac-specific troponin I (cTnI) level in patients after lung transplantation. Methods Clinical data of patients undergoing lung transplantation in our hospital from December 2016 to December 2022 were retrospectively analyzed. The relationship between postoperative serum cTnI level and clinical characteristics were explored. Results Finally 20 patients were collected, including 15 males and 5 females with an average age of (51.65±12.79) years. The serum cTnI level was significantly increased after lung transplantation. The serum cTnI reached the highest level on the first day after transplantation, and significantly decreased from the third day after transplantation. The serum cTnI levels in patients with obstructive pulmonary disease and bilateral lung transplantation were significantly higher than those in patients with restrictive pulmonary disease and unilateral lung transplantation on the day after surgery and on the first day after transplantation. Conclusion Transient myocardial injury can occur after lung transplantation, which is characterized by an abnormal increase in serum cTnI level.
Aortic dissection is a life-threatening cardiovascular disease with devastating complications and high mortality. It requires rapid and accurate diagnosis and a focus on prognosis. Many laboratory tests are routinely performed in patients with aortic dissection including D-dimer, brain natriuretic peptide, cardiac troponin I, C-reactive protein, and procalcitonin. D-dimer shows vital performance in the diagnosis of aortic dissection, and brain natriuretic peptide, cardiac troponin I, C-reactive protein, and procalcitonin exhibits important value in risk stratification and prognostic effect in aortic dissection patients. Our review summarized the clinical utility of these laboratory tests in patients with aortic dissection, aiming to provide advanced and comprehensive evidence for clinicians to better understand these laboratory tests and help their clinical practice.
Objective To evaluate the influences of myocardial injury markers on the short-term and long-term mortality after coronary artery bypass grafting (CABG), so as to provide valuable references for clinical prognosis assessment. Methods Literature was electronically searched in CBM, PubMed, OVID, EMbase and CNKI from the date of their establishment to August 2011, meanwhile the manual searches were also performed to systemize the papers. According to the Cochrane Handbook for systematic reviews, the studies were screened by two reviewers independently, the quality of the included studies was evaluated, the data were extracted, and meta-analysis was conducted using RevMan5.0 software. Results A total of 10 observational studies including creatine kinase-myocardial band (CK-MB) and cardiac troponin I (cTnI), and the patients involved were 10 793 totally. Results of meta-analysis showed that the increasing release of CK-MB was associated with an increasing short-term mortality risk of both on-pump (RR=2.88, 95%CI 1.94 to 4.28, Plt;0.000 01) and off-pump group (RR=3.64, 95%CI 1.07 to 12.42), P=0.04). Also the increasing release of CK-MB was associated with an increasing long-term mortality risk of both on-pump (RR=2.55, 95%CI 1.91 to 3.40, Plt;0.000 01) and off-pump group (RR=3.36, 95%CI1.46 to 7.72, P=0.004). The increasing release of cTnI was also associated with an increasing risk of both short-term mortality (RR=6.45, 95%CI 2.50 to 16.66, Plt;0.1) and long-term mortality (RR=4.18, 95%CI 2.78 to 6.28, Plt;0.1). Conclusion The evidence shows that the increasing release of both CK-MB and cTnI is associated with an increasing risk of the short-term and long-term mortality.