CAJ | 학술논문

目的　探讨心肌钙蛋白I (cTnI)用于监测非缺血性心肌损伤的临床意义。方法　将67例临床未见急性心肌梗死（AMI）迹象的可疑心肌损伤患者分为2组：（1）急性心衰组37例，患者心功能分级为Ⅳ级；（2）烧伤组30例，体表烧伤总面积为4%～98%。定期采集2组患者血样品，并用微粒子化学发光法检测样本cTnI浓度。结果　89%的急性心衰组患者cTnI水平升高（P＜0.001），且与病情变化密切相关。当患者病情恶化时，cTnI水平升高;病情改善时，cTnI水平逐渐下降。90%的烧伤组患者cTnI水平在烧伤后第5～14天期间呈轻到中度升高。平均值比对照组水平明显升高者，见于体表烧伤总面积＞30%(P＜0.001)或创面有明显渗出的患者（P＜0.002）。当患者创面渗出明显或焦痂自然剥离时，cTnI水平升至峰值,手术切痂后，cTnI水平逐渐下降。2例 cTnI水平持续性升高的患者发展为心动过速。结论　cTnI是一种敏感的非缺血性心肌损伤标志物，动态监测 cTnI水平变化有助于鉴别上述两类患者的心肌受损程度。
목적　탐토심기개단백I (cTnI)용우감측비결혈성심기손상적림상의의。방법　장67례림상미견급성심기경사（AMI）적상적가의심기손상환자분위2조：（1）급성심쇠조37례，환자심공능분급위Ⅳ급；（2）소상조30례，체표소상총면적위4%～98%。정기채집2조환자혈양품，병용미입자화학발광법검측양본cTnI농도。결과　89%적급성심쇠조환자cTnI수평승고（P＜0.001），차여병정변화밀절상관。당환자병정악화시，cTnI수평승고;병정개선시，cTnI수평축점하강。90%적소상조환자cTnI수평재소상후제5～14천기간정경도중도승고。평균치비대조조수평명현승고자，견우체표소상총면적＞30%(P＜0.001)혹창면유명현삼출적환자（P＜0.002）。당환자창면삼출명현혹초가자연박리시，cTnI수평승지봉치,수술절가후，cTnI수평축점하강。2례 cTnI수평지속성승고적환자발전위심동과속。결론　cTnI시일충민감적비결혈성심기손상표지물，동태감측 cTnI수평변화유조우감별상술량류환자적심기수손정도。
Objective　To investigate if cardiac troponin I (cTnI) could be used to monitor non-ischemic cardiac damage. Methods　Two categories of patients without clinical evidence of acute myocardial infarction but suspected to have cardiac damage were included: acute heart failure (n=37, heart function classified as class IV); and post burn injury (n=30, TBSA 4%～98%). Serum samples from these patients were analyzed for cTnI by chemiluminescent immunoassay. Results　Elevated plasma cTnI was found in 89% of patients with acute heart failure (P<0.001). Clinical conditions of the patients improved with declining of cTnI, while heart function deteriorated with the increasing of cTnI. Elevated plasma cTnI was also found between the 5th day to 14th day of post burn in 90% of burn patients. Mean cTnI level was significantly higher in patients with TBSA >30% (P<0.001) and in those patients with obvious burn wound exudation (P<0.002). cTnI peaked when obvious burn wound exudation or eschar spontaneous separation. cTnI decreased after surgical excision. Two patients with persistent high cTnI developed tachycardia. Conclusion　cTnI is a sensitive marker for non-ischemic cardiac damage. Monitoring of cTnI is useful in differentiating the two categories of patients.