高血压脑出血患者血清CKMB\cTnI和EKG异常改变的临床意义(1)
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【摘要】 目的 探讨高血压脑出血患者早期血清CKMB、cTnI和EKG异常改变与病情严重程度、出血量大小和出血部位的关系及其临床意义。方法 选择48例高血压脑出血患者,进行动态GCS评分及CT检查,计算出血量,判断出血部位及出血是否破入脑室,入院24 h内、72 h、7 d和15 d抽晨血测定CKMB、cTnI和心电图检查。结果 高血压脑出血患者在发病24 h内血清CKMB、cTnI和EKG异常率分别是12.50%、25.00%和54.17%,72 h异常率达到高峰,为33.33%、54.17%和77.08%,以后逐渐下降。发病72 h内有意识障碍组CKMB、cTnI和EKG异常率明显高于无意识障碍组,出血量>40 ml组明显高于出血量<40 ml组,差异有统计学意义;而不同出血部位和出血有无破入脑室组比较,其血清CKMB、cTnI和EKG异常率相近,对比差异无统计学意义。结论 高血压脑出血患者早期普遍存在血清CKMB、cTnI异常升高和心电图异常,其异常与脑出血量的大小及病情严重程度有关,与出血部位和出血是否破入脑室无关。高血压脑出血患者早期进行血清CKMB、cTnI监测和EKG检查对判断病情的严重程度有重要的临床意义。
【关键词】 高血压脑出血;肌酸激酶同工酶;肌钙蛋白I;心电图
The clinical significance of abnormal changes of CKMB、cTnI and EKG in the patients of hypertensivc cerebral hemorrhage
ZHENG Yuanhui,ZHENG Jinyi,ZHANG Jian.Department of Neuro Surgery,People’s Hospital of Cangnan,Zhejiang Cangnan325800,China
【Abstract】 Objective To explore the relations between abnormal changes of CKMB、cTnI and EKG and severity of illness,volume of blood and bleeding parts at early stage in the patients of hypertensivc cerebral hemorrhage and their clinical significance.Methods 48 patients of hypertensivc cerebral hemorrhage were selected,according to varying GCS scores and CT manifestation,to calculate blood volume,to judge bleeding parts and whether or not bleeding to break into encephalocoele. CKMB、cTnI and electrocardiogram were observed after 24 h,3 days,7 days and 15 days after hospital admission.Results 24 h later the abnormal rates of CKMB、cTnI and EKG are 12.50%,25.00%and 54.17%respectively,after 3 days they achieve peak,there respectively are 33.33%,54.17%and 77.08%,afterward they gradually degrade.the abnormal rates are higher in the patients who are conscious disturbance and bleeding volume exceeds 400 ml,there are significant differences between conscious disturbance group and no conscious disturbance group(P<0.05),but there are no significant differences in different bleeding parts group and whether or not bleeding breaks into encephalocoele(P>0.05).Conclusion The abnormal changes of CKMB、cTnI and EKG are universal in patients of hypertensivc cerebral hemorrhage,they are correlative with severity of illness and volume of blood,but not correlative with bleeding parts and whether or not bleeding breaks into encephalocoele ......
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