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目的:初步探讨围术期心肌缺血性疾病的诊断标准。方法:选择30例非心脏手术的老年患者(A组),测定其术前、术中、术毕和术后第1、2天的心肌酶谱和肌钙蛋白Ⅰ(cTnI)的值。30例经冠脉造影术(CAG)证实无冠脉病变的老年患者(B组),记录其PCI术前的心肌酶谱和cTnI的值。30例心内科急性心梗(AMI)老年患者(C组),测定其起病当天,起病后第1、2天的心肌酶谱和cTnI的值。结果:非心脏手术围术期除术前外,其余时间点的心肌酶谱与B组比较,均有显著差异(P<0.05);与C组比较,除CK外心肌酶谱各指标均未达到C组的标准。而非心脏手术围术期的cTnI与B组比较无显著差异(P>0.05),但与C组比较差异显著(P<0.05)。结论:cTnI是围术期心肌缺血性疾病的特异性指标。
Objective: To investigate the diagnostic criteria of perioperative myocardial ischemic disease. Methods: Thirty patients with non-cardiac surgery were enrolled in the study. The myocardial enzymes and cTnI were measured preoperatively, intraoperatively, and at the first and second postoperative days. Thirty patients with coronary artery disease (group C) who were confirmed by coronary angiography (group C) were enrolled in this study. Their myocardial enzymes and cTnI were recorded before PCI. Thirty patients with acute myocardial infarction (AMI) in the elderly were enrolled in the study. The myocardial enzymes and the cTnI values of the patients on the day of onset and on the first and second days after onset were measured. Results: Compared with group B, myocardial enzymes of non-cardiac surgery were significantly different (P <0.05) except pre-operation, compared with those of group B C group to achieve the standard. The perioperative cTnI was not significantly different from that of the B group (P> 0.05), but significantly different from that of the C group (P <0.05). Conclusion: cTnI is a specific indicator of perioperative myocardial ischemic disease.