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目的:观察结核病患者血清酶学、心肌肌钙蛋白I(cTnI)的变化,进一步了解其在结核病患者中的临床意义。方法:收集2010年5月—2011年12月确诊的结核病患者80例,检测入院时的血清酶学、cTnI,结果异常者每周复查1次。结果:80例患者中肺结核39例,结核性胸膜炎24例,结核性多浆膜腔积液(包括心包腔积液)17例;入院时测得天冬氨酸转氨酶(AST)、肌酸激酶(CPK)、乳酸脱氢酶(LDH)值均正常,2例血清丙氨酸转氨酶(ALT)轻度偏高;10例结核性多浆膜腔积液(包括合并心包腔积液)患者cTnI异常,均伴随胸痛症状;cTnI异常者在抗结核治疗的同时加用甘油果糖,症状减轻,最长1例达20 d症状消失,cTnI值恢复正常。结论:结核性多浆膜腔积液(包括合并心包腔积液)的患者出现胸痛症状时要想到及时检测cTnI;结核病患者测得cTnI值异常时有临床意义,说明心肌已经受累,需要与冠心病、肺栓塞等疾病鉴别,及时给予综合治疗。
Objective: To observe the changes of serum enzymology, cardiac troponin I (cTnI) in patients with tuberculosis and to further understand its clinical significance in patients with tuberculosis. Methods: 80 cases of TB patients diagnosed from May 2010 to December 2011 were collected. Serum enzyme cTnI and cTnI were detected on admission. The patients with abnormal results were reviewed weekly. Results: Among the 80 patients, there were 39 cases of tuberculosis, 24 cases of tuberculous pleurisy and 17 cases of tuberculous pleural effusion (including pericardial effusion). Aspartate aminotransferase (AST), creatine kinase CPK and LDH were normal, and serum alanine aminotransferase (ALT) was slightly elevated in 2 patients. In 10 patients with tuberculous pleural effusion (including pericardial effusion), cTnI Abnormalities were accompanied by chest pain symptoms; cTnI abnormalities in the anti-TB treatment with glycerol plus fructose, reduce the symptoms, up to 1 d up to 20 d symptoms disappear, cTnI values returned to normal. CONCLUSIONS: Patients with tuberculous multi-serous effusion (including those with pericardial effusion) are expected to have cTnI detected promptly in patients with chest pain. TB patients with abnormal cTnI values have clinical implications indicating that the myocardium has been compromised, Heart disease, pulmonary embolism and other diseases identified in a timely manner to give comprehensive treatment.