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目的探讨血清肌酸激酶同工酶MB(CK-MB)和心肌钙蛋白T(cTnT)水平评估先天性心脏病(CHD)介入治疗后心肌损伤的价值。方法接受心导管介入封堵术CHD患儿152例分为继发孔型房间隔缺损(ASD组,49例)、膜部室间隔缺损(VSD组,61例)和动脉导管未闭(PDA组,42例)三组,免疫抑制法和化学发光法检测术前、术后即刻及术后48h血清CK-MB和cTnT水平。结果三组患儿术前血清CK-MB和cTnT均在正常水平。ASD、VSD组术后即刻血清CK-MB水平均升高(P<0.05或P<0.01);VSD组术后48h血清CK-MB水平低于术后即刻(P<0.05)。三组术后即刻血清cTnT水平均升高(P<0.05或P<0.01)。三组术后48h血清cTnT水平均下降(P<0.05),但VSD、PDA组仍高于术前(P<0.05)。结论检测血清CK-MB和cTnT两项指标均可用于评估CHD患儿介入治疗后心肌损伤,血清cTnT水平更敏感。
Objective To investigate the value of serum creatine kinase MB (CK-MB) and cardiac troponin T (cTnT) levels in the assessment of myocardial injury after interventional treatment of congenital heart disease (CHD). Methods A total of 152 children with CHD undergoing cardiac catheterization were divided into two groups: secundum atrial septal defect (ASD group, 49 cases), ventricular septal defect (VSD group, 61 cases) and patent ductus arteriosus (PDA group, 42 cases). Immunosuppression and chemiluminescence were used to detect the serum levels of CK-MB and cTnT immediately before operation, immediately after operation and 48 hours after operation. Results The preoperative serum CK-MB and cTnT in all three groups were normal. Serum levels of CK-MB in ASD and VSD groups were significantly increased after operation (P <0.05 or P <0.01). Serum levels of CK-MB in VSD group were lower than those immediately after operation (P <0.05). The level of serum cTnT immediately after operation in all three groups increased (P <0.05 or P <0.01). The level of serum cTnT decreased 48h after operation in all three groups (P <0.05), but still higher than that in the VSD and PDA groups (P <0.05). Conclusion The two indexes of serum CK-MB and cTnT can be used to evaluate myocardial injury after interventional treatment in children with CHD, and serum cTnT level is more sensitive.