肺心病患者71例心肌酶谱临床分析(1)
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[摘要] 目的 探讨肺心病患者心肌酶谱变化的临床意义。 方法 71例肺心病患者分别于入院当天、治疗后5 d、10 d和15 d测心肌酶谱。入院后均给予吸氧、抗生素、解痉化痰等综合治疗。出院后系统随访1年。 结果 随着NYHA心功能级别的增高，肺心病患者心肌酶谱LDH、α-HBDH、CK和CKMB的值均相应增高。心功能Ⅳ级组心肌酶谱升高尤为明显。肺心病治疗有效的患者心肌酶谱有明显的下降；治疗好转的患者心肌酶谱在治疗后也有不同程度的下降，但不明显；而治疗无效的患者，心肌酶谱在治疗后一直维持在较高的水平。随访1年内，心肌酶谱正常的患者再入院率为5.3%，而心肌酶谱异常患者的再入院率为28.9%。入院心肌酶谱是影响肺心病患者再入院的独立危险因素。 结论 肺心病患者的心肌酶谱与病情密切相关，并且能够影响治疗效果和预后。
[关键词] 肺心病；心肌酶谱；疗效；预后
[中图分类号] R541.5 [文献标识码] A [文章编号] 1673-9701(2012)01-003-03
The significance of myocardial enzymes for pulmonary heart disease
GAO Heyou
Internal Medicine Department, the Forth People's Hospital of Haining City in Zhejiang Province，Haining 314411，China
[Abstract] Objective To investigate the clinical significance of myocardial enzymes changes in patients with pulmonary heart disease. Methods All of 71 patients with chronic pulmonary heart disease were admitted to hospital. At the admitted day, 5, 10 and 15 day after treatment, myocardial enzymes were measured. All patients were given oxygen, antibiotics, antispasmodic phlegm and other comprehensive treatment, and then gave 1 year follow-up after discharge. Results With the increase of NYHA heart functional class, myocardial enzymes LDH, α-HBDH, CK and CKMB values in patients with pulmonary heart disease were correspondingly increased. Cardiac function Ⅳ group especially elevated myocardial enzymes. The myocardial enzymes significantly decreased after effective treatment; The myocardial enzymes also declined in improved patients, but not obvious; And in ineffective treatment patients, myocardial enzymes had been maintained at more high level. After 1 year follow-up, patients with normal myocardial enzyme readmission rate was 5.3%, Vs 28.9% in patients with abnormal myocardial enzymes. Myocardial enzymes were independent risk factors that affect hospital readmission in patients with pulmonary heart disease. Conclusion The myocardial enzymes in patients with pulmonary heart disease are closely related with state of an illness and can affect treatment and prognosis.
[Key words] Pulmonary heart disease; Myocardial enzymes; Effect; Prognosis
心肌酶是存在于心肌的多种酶的总称，一般有天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)及同功酶(LDH1)、α-羟丁酸脱氢酶(α-HBDH)和肌酸激酶(CK)及同工酶(CKMB) ......
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