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目的通过动态监测血清心肌型脂肪酸结合蛋白(H-FABP)和心肌肌钙蛋白I(cTnI),研究使用国产封堵器进行介入治疗先天性心脏病(先心病)时,心肌标志物在不同时间点心肌损伤程度。方法随机选取先心病介入治疗患儿30例,动态监测cTnI、H-FABP的变化。结果30例先心病患儿血清H-FABP、cTnI术前浓度分别为(1.28±0.19)、(0.020±0.003)ng/ml,术后5~15 min分别为:(8.51±1.82)、(0.46±0.18)ng/ml,术后4 h为:(2.31±0.58)、(0.66±0.15)ng/ml,24 h明显下降,各时间点差异有显著性(P<0.01)。结论先心病介入治疗存在心肌微小损伤;H-FABP较cTnI有更早的峰值浓度出现,是早期判断心肌损伤的良好指标;测量cTnI、H-FABP可为临床防治术后并发症提供科学依据。
Objective To investigate the clinical significance of myocardial markers in patients with congenital heart disease (CHD) treated by domestic occluder by dynamic monitoring of serum myocardial fatty acid binding protein (H-FABP) and cardiac troponin I (cTnI) Myocardial injury level. Methods Thirty children with CHD were selected randomly to monitor the changes of cTnI and H-FABP. Results The preoperative concentrations of H-FABP and cTnI in 30 patients with CHD were (1.28 ± 0.19) and (0.020 ± 0.003) ng / ml, respectively, and were significantly higher at 5-15 min (8.51 ± 1.82 and 0.46 ± 0.18) ng / ml. After 4 hours of operation, it was (2.31 ± 0.58) and (0.66 ± 0.15) ng / ml significantly decreased at 24 h, and the difference was significant at all time points (P <0.01). Conclusion H-FABP has earlier peak concentration than cTnI, which is a good indicator of myocardial damage in the early stage of interventional therapy. Measurement of cTnI and H-FABP may provide a scientific basis for clinical prevention and treatment of postoperative complications.