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·心血管疾病研究专题· 心肌酶谱检测在预测中暑患者病情严重程度中的应用价值

Value of myocardial zymogram detection in prediction of severity of heatstroke

    摘要
  • 摘要:
      目的  探讨心肌酶谱检测在预测中暑患者病情严重程度中的应用价值。
      方法  选择本院中暑患者70例作为观察组，其中轻症中暑患者55例纳入观察A组，重症中暑患者15例为观察B组。另选择同期在本院进行健康体检人群106例作为对照组。统计观察组治疗前后及对照组的心肌酶谱变化情况，分析治疗前心肌酶谱各项指标对轻症及重症中暑患者的预测价值。
      结果  观察组治疗前血清谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、α羟丁酸脱氢酶(α-HBDH)含量均显著高于对照组(P < 0.05); 观察组治疗后与对照组血清α-HBDH含量差异无统计学意义(P>0.05), 观察组治疗后血清AST、LDH、CK含量均显著高于对照组(P < 0.05), 观察组治疗后CKMB含量显著低于对照组(P < 0.05)。观察A组、观察B组治疗前血清CK、α-HBDH含量差异无统计学意义(P>0.05), 观察A组治疗前血清AST、LDH、CKMB含量均显著低于观察B组(P < 0.05); 观察A组、观察B组治疗后血清AST、LDH、CK、α-HBDH含量差异无统计学意义(P>0.05)。观察A组治疗后血清CKMB含量显著低于观察B组(P < 0.05)。ROC曲线分析结果显示，治疗前血清AST曲线下面积0.729(95%CI: 0.610~0.828), LDH曲线下面积0.685(95%CI: 0.563~0.791), CK曲线下面积0.650(95%CI: 0.527~0.760), CKMB曲线下面积0.862(95%CI: 0.759~0.933), HBDH曲线下面积0.628(95%CI: 0.505~0.741)。
      结论  中暑患者心肌酶谱水平变化明显，治疗前心肌酶谱变化对中暑患者病情判断有一定的指导意义，且血清CKMB水平随疾病变化最为明显。

     

    Abstract:
      Objective  To study value of myocardial zymogram detection in prediction of severity of heatstroke in patients.
      Methods  A total of 70 patients with heatstroke in our hospital were selected as observation group, and were subdivided into observation group A(n=55, mild heatstroke) and observation group B(n=15, severe heatstroke). In addition, a total of 106 people who performed physical examination in our hospital at the same time were selected as control group. The changes of myocardial zymogram in the observation group before and after treatment and the control group were observed, and the value of myocardial zymogram indicators before treatment in prediction of mild and severe heatstroke was analyzed.
      Results  Before treatment, the levels of glutamic oxaloacetic transaminase(AST), lactic dehydrogenase(LDH), creatine kinase(CK), creatine phosphate kinase(CKMB) and α-hydroxybutyrate dehydrogenase(α-HBDH) in serum in the observation group were significantly higher than that in the control group (P < 0.05). After treatment, there was no significance difference in serum HBDH between the observation group and the control group (P>0.05), the levels of serum AST, LDH and CK in the observation group were higher than those in the control group (P < 0.05), and the level of CKMB in the observation was lower than that in the control group (P < 0.05). Before treatment, there were no significance differences in CK and HBDH between the observation group A and observation group B (P>0.05), the levels of AST, LDH and CKMB in the observation group A were lower than those in the observation group B (P < 0.05); after treatment, there were no significance differences in AST, LDH, CK and α-HBDH between the observation group A and observation group B (P>0.05). The level of CKMB in the observation group A was lower than that in the observation group B (P < 0.05). The ROC curve analysis showed that, before treatment, the area under the serum AST curve, LDH curve, CK curve and CKMB curve were 0.729 (95%CI: 0.610~0.828), 0.685 (95%CI: 0.563~0.791), 0.650 (95%CI: 0.527~0.760), 0.862 (95%CI: 0.759~0.933), and 0.628 (95%CI: 0.505~0.741), respectively.
      Conclusion  The changes of myocardial zymogram in patients with heatstroke are obvious, and it is of great significance in judging the conditions of heatstroke, and change of serum CKMB level is most obvious with development of disease.

     

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