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危重患者心肌肌钙蛋白 肌红蛋白的检测及其意义 被引量:3

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摘要 目的探讨危重病患者血清心肌肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(MYO)的水平变化及在危重病患者急性心肌损伤的诊断、评价病情严重程度及患者预后中的作用。方法对入住外科ICU和急诊ICU的93例危重病患者,在24小时内以化学发光法检测血清cTnⅠ和MYO水平,同时对患者进行APACHⅡ评分。结果在93例危重病患者中cTnⅠ升高21例,占22.6%,在21例cTnⅠ升高患者中死亡9例,占42.9%,不同APACHEⅡ评分、死亡组与存活组患者cTnⅠ水平均存在显著差异(P<0.01),cTnⅠ升高患者的死亡率、低血压发生率、心衰及心律失常发生率均显著高于cTnⅠ正常患者(P<0.01),MYO在93例危重病患者中均有不同程度升高,不同APACHEⅡ评分、死亡组与存活组均存在显著性差异(P<0.01),APACGEⅡ分值>20分组显著高于<20分组,死亡组显著高于存活组。结论血清cTnⅠ水平对诊断危重患者的心肌损伤、判断病情严重程度及患者预后有重要价值,对诊断危重病患者的心肌损伤具有高度特异性,血清MYO水平在危重病患者中均有不同程度升高,病情愈严重,升高愈显著,可反映危重病患者的病情严重程度及判断预后,但对心肌损伤的诊断缺乏特异性。
作者 董勤亮
出处 《医药论坛杂志》 2009年第9期49-50,共2页 Journal of Medical Forum
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