CAJ | 학술논문

目的：探讨胸部钝挫伤患者血清中心肌损伤标志物的动态变化规律及其对心肌损伤的诊断意义。方法选择武警江苏总队医院住院治疗的胸部钝挫伤82例为观察组，全部胸部钝挫伤患者（ ISS≥16分）根据有无合并心肌损伤分为两组，即合并心肌损伤组（A组），无合并心肌损伤组（B组），分别对两组患者伤后3 h、6 h、12 h、48 h血清肌钙蛋白Ⅰ（cTnI）、心肌特异脂肪酸结合蛋白（ H-FABP）、肌红蛋白（ Mb）进行检测，同法测定60名健康体检者血清相应指标作为对照组。结果两观察组在不同时段血清cTnI、H-FABP及Mb浓度均高于对照组，其中A组在伤后6～48 h，cTnI、H-FABP浓度均明显高于B组，差异有统计学意义（ P ＜0．01）。同时段 A、B 两组 Mb 浓度虽均高于对照组，但两组组间比较差异无统计学意义。结论血清cTnI、H-FABP、Mb的动态变化与胸部钝挫伤患者病情严重程度、变化趋势及预后具有良好相关性，对心肌损伤早期诊断、治疗具有重要意义。
목적：탐토흉부둔좌상환자혈청중심기손상표지물적동태변화규률급기대심기손상적진단의의。방법선택무경강소총대의원주원치료적흉부둔좌상82례위관찰조，전부흉부둔좌상환자（ ISS≥16분）근거유무합병심기손상분위량조，즉합병심기손상조（A조），무합병심기손상조（B조），분별대량조환자상후3 h、6 h、12 h、48 h혈청기개단백Ⅰ（cTnI）、심기특이지방산결합단백（ H-FABP）、기홍단백（ Mb）진행검측，동법측정60명건강체검자혈청상응지표작위대조조。결과량관찰조재불동시단혈청cTnI、H-FABP급Mb농도균고우대조조，기중A조재상후6～48 h，cTnI、H-FABP농도균명현고우B조，차이유통계학의의（ P ＜0．01）。동시단 A、B 량조 Mb 농도수균고우대조조，단량조조간비교차이무통계학의의。결론혈청cTnI、H-FABP、Mb적동태변화여흉부둔좌상환자병정엄중정도、변화추세급예후구유량호상관성，대심기손상조기진단、치료구유중요의의。
Objective To investigate the dynamic changes of myocardial injury markers in blunt trauma patients ’ serum and its significance in diagnosis of trauma complicated by myocardial injury .Methods According to the presence or absence of myocardial injury, 82 cases of blunt trauma patients ( ISS≥16) from December 2011 to December 2013 in this hospital were assigned to group A ( presence of myocardial injury ) and B ( absence of myocardial injury ) .Troponin Ⅰ ( cTnI ) , heart fatty acid-binding protein ( H-FABP) , and myoglobin (Mb) were detected 3 h, 6 h, 12 h, 48 h after injury in serum of group A, B and 60 healthy persons (control group) .Results Concentrations of cTnI , H-FABP and Mb were significantly higher than those in the control group at different times . Concentrations of cTnI and H-FABP in group A were significantly higher than those in group B (P<0.01).The concentration of Mb in group A, B was higher than that in control group, but the difference between the groups A and B was not significant (P>0.05). Conclusions There is a good correlation between the dynamic changes of cTnI , H-FABP and Mb in serum and severity of illness , var-iation tendency and prognosis of blunt chest trauma patients , which is important for early diagnosis and treatment of myocardial injury . Combined with other examination methods (X-ray, ECG, blood gas analysis, color Doppler echocardiography ), detection of myocardial injury markers has a high clinical value in treatment of blunt chest trauma complicated by myocardial injury .