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find Keyword "肌钙蛋白" 30 results
  • Changes and Clinical Significance of the Level of Plasma Brain Natriuretic Peptide and Carolic Troponin I in Patients with Heart Failure

    目的 探讨血浆脑钠肽(BNP)及血清肌钙蛋白I(cTNI)含量改变在老年患者发生充血性心力衰竭时的临床意义。 方法 选择2010年7月-2012年8月住院的各种老年心脏病患者117例,根据纽约心功能分级分为4组(心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组),分别检测血浆BNP、血清cTNI及心肌酶[肌酸磷酸激酶(CK)、肌酸磷酸激酶同工酶(CK-MB)]进行组间比较,同时与健康老年组进行对比。 结果 ① 老年慢性充血性心力衰竭各组(心功能Ⅱ~Ⅳ级)血浆BNP水平均高于健康对照组及心功能正常组(心功能Ⅰ级组);且心功能Ⅳ级组BNP水平>心功能Ⅲ级组>心功能Ⅱ级组。各组之间比较差异有统计学意义,但心功能Ⅰ级组与健康对照组血浆BNP水平无明显差异。② 各组之间CK及CK-MB水平差异均无统计学意义。③ 充血性心力衰竭各组(心功能Ⅱ~Ⅳ级组血清cTNI水平均高于健康对照组及心功能正常组(心功能Ⅰ级组);且心功能Ⅳ级组cTNI水平>心功能Ⅲ级组>心功能Ⅱ级组。各组之间比较差异有统计学意义,而心功能Ⅰ级组及健康对照组血清cTNI水平差异无统计学意义。 结论 血浆BNP水平及血清cTNI水平在老年患者发生心力衰竭时随心力衰竭程度加重而逐渐升高,两者均对慢性充血性心力衰竭的临床诊断具有重要参考意义。

    Release date:2016-08-26 02:09 Export PDF Favorites Scan
  • Clinical Value of Cardiac Troponin I in the Early Postoperative Period of Off-pump Coronary Artery Bypass Grafting

    Objective To identify clinical significance of high level cardiac troponin I (cTnI) in the early postoperative period of off-pump coronary artery bypass grafting (OPCAB) and its predictive value for early clinical outcomes. Methods A total of 240 patients undergoing isolated OPCAB in the Department of Cardiac Surgery of People’s Hospitalof Peking University during 2011 were recruited in the study. There were 164 males and 76 females with their age of 36-83(62.07±8.24) years. Serum cTnI levels in 4-6 hours and 12-18 hours after OPCAB were monitored. Influential factors and its predictive value for early clinical outcomes of OPCAB were analyzed. Binary logistic regression analysis,correlation analysis and receiver operating characteristic (ROC) curve were performed for statistic analysis. Results Serum cTnI level in 4-6 hours after OPCAB (TNI0) was 1.28±0.40 ng/ml,and serum cTnI level in 12-18 hours after OPCAB (TNI1) was 3.60±0.74 ng/ml. Binary logistic regression analysis revealed that graft number was significant influential factors of TNI0 (P=0.000) and TNI1 (P=0.010). Serum cTnI level in 12-18 hours after OPCAB was significantly correlated with early clinicaloutcomes of OPCAB (P<0.05),but the correlational relationship was not b (correlation coefficient<0.5). ROC curveanalysis showed that serum cTnI level in 12-18 h after OPCAB had higher predictive value for patient prognosis (P<0.05). Serum cTnI level higher than 1.49 ng/ml in 12-18 h after OPCAB had good predictive value for postoperative ECG changes,use of intra-aortic balloon pump (IABP) and in-hospital mortality. Conclusions Serum cTnI level increases in varying degrees in the early postoperative period of OPCAB. Together with ECG changes,serum cTnI level can be used for early diagnosis of perioperative myocardial infarction with significant predictive value for early clinical outcomes of OPCAB.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • Protection Effect of Isolated Ischemic Heart by Polyethylene Glycolbovine Hemoglobin Solution

    Objective To investigate the effect of polyethylene glycolbovine hemoglobin (PEG-bHb), which was used as an oxygen carrier in cardioplegic solution, on the protection of isolated rat hearts. Methods The hearts of 32 male SD rats were harvested and transferred to Langendorff circuit. They were divided into 4 groups according to cardiocplegia: St.Thomas group (group A), 1∶2 PEG-bHb group (group B), 1∶4 PEG-bHb group (group C) and 1∶8 PEG-bHb group (group D). After 20min balance period, hearts were perfused with cold (4℃) cardioplegic solutions, and preserved at 30℃ for 60min, then reperfused. Levels of cardiac troponin I (cTn I) and adenosine triphosphate(ATP) contant in coronary effuent were detected, and ultrastructures of myocardium were observed. Results After reperfusion, cTn I contant of group A were higher (F=52.955,Plt;0.05) and ATP contant were lower (F=68.757,Plt;0.05) than those in group B, group C and group D. Myocardial water contant were lower in group B and group C(F=3.048,Plt;0.05). Conclusion PEG-bHb in cardioplegic solutions can provide better myocardial protection during ischemia.

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Effects of Ischemic Preconditioning on Myocardial Preservation in Patients Undergoing Cardiac Valve Replacement

    Objective To investigate whether single cycle ischemic preconditioning (IP) improves the myocardial preservation in patients undergoing cardiac valve replacement. Methods From August 2002 to April 2006, 85 patients who had chronic heart valve disease and required cardiac valve replacement were randomly divided into two groups. IP group, 47 allocated to receive IP and arrested with 4 C St. Thomas' Hospital cardioplegic solution during cardiopulmonary bypass(CPB), preconditioning was accomplished by using single cycle of 2 minutes occlusion of aorta followed by 3 minutes of reperfusion before cross-clamping. Control group, 38 allocated to receive 4 C St. Thomas' Hospital cardioplegic solution alone. Myocardial protective effects were assessed by determinations of creatinine kinase-MB isoenzyme (CK-MB) and cardiac troponin I(cTnI), ST-T changes, ventricular arrhythmias and other clinical data in ICU. Results Serum CK-MB and cTnI concentrations were increased postoperatively in two groups. At 24, 48 and 72h after operation, values of CK-MB in IP group was significantly lower than that in control group (P〈0.05), cTnI at 24 and 48h after operation also less in IP group (P〈0.05). The duration for patients needed for antiarrhythmic drugs in IP group was lower than that in control group (P〈0.05). Compared with control group, fewer inotropic drugs were used in IP group. As a result, ICU stay time in IP group was shorter than that in control group (P〈0.05). Conclusion IP enhances the myocardial protective effect when it was used with hypothermic hyper kalemic cardioplegic solution in patients undergoing cardiac valve replacement, IP significantly reduces the postoperative increase of CK-MB, cTnI and plessens the severity of postoperative ventricular arrhythmias.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • 心脏不停跳与冷晶体停搏在常见先心病矫治术中对肌钙蛋白I的影响

    目的 探讨常见先天性心脏病矫治术中心脏不停跳与心脏停搏两种术式对心肌肌钙蛋白 I(c Tn I)的影响及其心肌保护的效果。 方法  36例先天性心脏病矫治术患者按入院顺序以奇偶数随机分为心脏不停跳组 (组II)和冷晶体停搏组 (组I)两组 ,每组 18例。分别于术前、主动脉开放后 (组 为缝合右心房壁后 ) 1、2 4、4 8、72和 96 h取患者中心静脉血 ,测定 c Tn I、肌酸激酶 (CK)、肌酸激酶同工酶 (CK- MB)、乳酸脱氢酶 (L DH) ,并用透射电子显微镜观察两组各前 10例患者心内操作前、后心肌超微结构。 结果 两组术后血清 c Tn I、CK、CK- MB和 L DH水平均不同程度升高。两组 c Tn I均于术后 1h达峰值 ,主动脉开放后各时点组II显著高于组I(t=- 32 3.0 4 ,Plt;0 .0 1) ;组ICK-MB术后 2 4 h达峰值 ,组II术后 1h达峰值 ,主动脉开放后各时点组II显著高于组I(t=- 72 .5 3,Plt;0 .0 1) ;CK、L DH变化趋势与 CK- MB相似。组I术后心肌超微结构变化轻微 ,组II明显改变 ,...更多其受损程度分级较术前重。 结论 常见先天性心脏病矫治术中心脏不停跳可明显减轻心肌缺血、缺氧及再灌注损伤 ,减少 c Tn I的释放 ,较冷晶体停搏术有良好的心肌保护效果。

    Release date:2016-08-30 06:24 Export PDF Favorites Scan
  • 体外循环缺血-再灌注心肌肌钙蛋白I丢失与心功能障碍的关系

    目的 探讨体外循环缺血-再灌注心肌肌钙蛋白I(TnI)丢失与心功能障碍的关系. 方法 12条雄性杂种狼犬,按体外循环升主动脉阻断时间不同分为两组:组Ⅰ(n=6):主动脉阻断25分钟;组Ⅱ(n=6):主动脉阻断150分钟.分别于转流前、主动脉开放后10分钟、30分钟、60分钟时测定动脉和冠状静脉窦血清TnI浓度,同时监测围术期冠状静脉窦血流量和血流动力学. 结果 再灌注后冠状静脉窦血清TnI浓度持续高于动脉血清TnI浓度(P<0.01),提示心肌丢失TnI.组Ⅱ与组Ⅰ比较,组Ⅱ心肌TnI丢失水平更显著,且终止体外循环后心脏指数、每搏指数、左心室每搏作功指数均显著降低(P<0.05). 结论 体外循环缺血-再灌注心肌TnI丢失程度与心功能障碍的发生密切有关,提示心肌细胞TnI丢失很可能是导致缺血后心肌功能障碍的分子基础之一.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 逆行性灌注浅低温氧合血心脏不停跳与冷血心脏停搏液对cTn I的影响

    目的 对比研究逆行性灌注浅低温氧合血心脏不停跳与低温冷血心脏停搏液对外周血清心肌肌钙蛋白I(cTn I)的影响. 方法 将18例双瓣膜置换术患者分为心脏不停跳组和心脏停搏组,观察围手术期外周血清cTn I、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及主动脉阻断前后用透射电子显微镜观察心肌超微结构变化.结果 心脏不停跳组主动脉开放后各个时相点CK虽略低于心脏停搏组,但差别无显著性意义(Pgt;0.05);主动脉开放后6小时CK-MB明显低于心脏停搏组(Plt;0.05),主动脉开放后各个时相点心脏不停跳组cTn I明显低于心脏停搏组(Plt;0.05).两组患者主动脉阻断前心肌超微结构均有轻度改变,主动脉阻断90分钟心脏停搏组心肌超微结构损伤较心脏不停跳组明显. 结论 逆行性灌注浅低温氧合血心脏不停跳围手术期外周血清cTn I较低,可能与该方法使体外循环期间发生不可逆损伤的心肌细胞较少,心肌超微结构损伤较轻有关.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 冠状动脉旁路移植术后血清肌钙蛋白T的动态变化

    目的 研究冠状动脉旁路移植术(CABG)后血清肌钙蛋白T(TnT)的动态变化及临床意义。方法 采用双抗体夹心酶联免疫吸附测定法(ELISA),测定37例患者CABG后血清TnT的浓度变化,并与肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)进行比较。结果 TnT在CABG后4~12小时达到峰值,术后6~8天恢复正常。CK-MB于术后4~16小时升至峰值,术后48小时即恢复正常。CABG后TnT峰值与主动脉阻断时间呈正相关(r=0.55,P<0.05)。结论 TnT在CABG后对于诊断微小心肌损伤、判断预后具有高特异性、高敏感性。

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • 心瓣膜置换术前使用低浓度极化液对心肌保护作用的评价

    目的评价心瓣膜置换术前使用低浓度极化液(GIK)对心肌的保护作用. 方法将46例心瓣膜置换术患者分为两组,GIK组和对照组,应用微粒子化学发光法检测心肺转流术前、后,术后 10小时、24小时、72小时、150小时心肌肌钙蛋白I ( cTn-I )、磷酸肌酸激酶同工酶(CK-MBmass)、肌红蛋白( Myob )的浓度,比较两组间心肌酶、心功能情况及临床预后. 结果两组间 cTn-I,CK-MBmass和Myob在术前、术中、术后的浓度差别均无显著性意义(P>0.05);GIK组cTn-I,CK-MBmass和Myob的浓度与低浓度GIK使用时间无相关性(P>0.05);两组间心脏自动复跳率、术后升压药使用率、LCOS、心律失常发生率和住院死亡率差别均无显著性意义(P>0.05). 结论术前使用低浓度GIK对术后心肌损伤无保护作用.

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • 腺苷预处理对体外循环术后心肌肌钙蛋白变化的影响

    目的 探讨腺苷预处理对心脏直视手术的心肌保护效果.方法 30例择期心瓣膜置换术患者随机分成实验组和对照组,每组15例.实验组在术前行腺苷预处理.分别于转流前、主动脉阻断30分钟和60分钟、主动脉开放后30分钟及术后24小时采血测定心肌肌钙蛋白T(cTnT)、心肌酶谱和丙二醛.结果 腺苷预处理者cTnT和心肌酶外漏明显减少,丙二醛生成减少.结论 腺苷预处理能减轻心肌缺血再灌注损伤.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
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