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目的 为探索烫伤后心肌舒缩功能及心肌肌钙蛋白T(cTnT)变化在心肌损伤诊断中的应用。方法 复制大鼠 30 %TBSAⅢ度烫伤动物模型。 56只大鼠随机分成烫伤前及烫伤后 1、3、6、12、2 4、4 8、72h共8组 ,观察各时相点左心室力学参数 (LVSP、LVEDP、±dp/dtmax) ;血清cTnT、CK、LDH含量及心脏病理形态学变化。结果 ①烫伤后 1h -dp/dtmax显著下降 ,LVEDP明显升高 ;LVSP、+dp/dtmax伤后 3h显著下降 ,均于 12h变化最大 ,至 72h变化仍较明显 (P <0 0 1)。 3h后光镜下可见心肌病理性改变。②cTnT于伤后 1h显著上升 ,12h比对照值升高 4 3倍 ,至 72h仍保持在高水平 ;而LDH、CK分别于伤后 3、6h开始上升 ,至 72h已接近正常 (P >0 0 5)。结论 ①大鼠严重烫伤后左心室舒缩功能明显下降 ,且舒张功能障碍的发生早于收缩功能。②cTnT与心肌酶谱 (CK、LDH)比较 ,具有出现早、高特异、高灵敏等特点 ,是诊断烧伤后心肌损伤的可靠指标
Objective To explore the application of myocardial relaxation and contraction function and cardiac troponin T (cTnT) changes in the diagnosis of myocardial injury after scald. Methods Rat model of 30% TBSA Ⅲ degree burns was reproduced. Fifty - six rats were randomly divided into 8 groups at 1, 3, 6, 12, 24, 48 and 72 hours after scald. The left ventricular mechanical parameters (LVSP, LVEDP, ± dp / dtmax) were observed at different time points. Serum cTnT, CK, LDH levels and changes in cardiac pathology. Results ① After 1 h scald, the level of -dp / dtmax decreased significantly and LVEDP increased significantly. LVSP and + dp / dtmax decreased significantly 3h after injury, both of which changed most significantly at 12h and remained significant at 72h (P <0.01). Pathological changes of myocardium were observed under light microscope 3h later. ② The level of cTnT increased significantly 1 h after injury, increased 4 3 times at 12 h and remained high at 72 h, while LDH and CK increased at 3 h and 6 h, respectively, and reached the normal level at 72 h (P 0 0 0 5). Conclusions ① The left ventricular systolic and diastolic function decreased significantly after severe scald in rats, and the diastolic dysfunction occurred earlier than the systolic function. ② Compared with myocardial enzymes (CK, LDH), cTnT has the features of early, high specificity and high sensitivity, which is a reliable indicator of myocardial injury after burn injury