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目的观察血清肌钙蛋白Ⅰ在HELLP综合征疾病中的含量和变化规律,探讨HELLP综合征时心肌损伤的程度和临床价值。方法对38例HELLP综合征患者心肌肌钙蛋白Ⅰ(cTnI)的含量进行测定,并动态观察重症患者随病情变化规律,动态观察心肌受损程度。结果HELLP综合征组与正常孕妇组比较,P<0.01,有非常显著差异。HELLP综合征组肌钙蛋白Ⅰ明显高于正常孕妇组。38例HELLP患者中,8例肌钙蛋白Ⅰ在(0.4-3.9)ng/mL之间,占本组的21.05%(8/38);30例肌钙蛋白Ⅰ含量在(0.001-0.4)ng/mL之间,占本组的78.94%(30/38),并有5例肌钙蛋白I的含量在(0.27-0.4)ng/mL,占本组的13.15%(5/38)。动态观察发现8例肌钙蛋白I(0.4-3.9)ng/mL之间者,有4例患者肌钙蛋白Ⅰ含量随病情加重而增高,其中3例出现了心电图异常改变;3例患者在(0.4-3.9)ng/mL以上,维持在一个高水平数日后,逐渐下降。另5例肌钙蛋白Ⅰ的含量在(0.27-0.4)ng/mL之间者中,有1例在动态观察中血清肌钙蛋白Ⅰ的含量由0.27 ng/mL升至1.4ng/mL,并维持数日。结论cTnI可作为判断HELLP综合征患者心肌细胞受损的理想指标。
Objective To observe the content and variation of serum troponin Ⅰ in HELLP syndrome and to explore the extent and clinical value of myocardial injury in HELLP syndrome. Methods The levels of cTnI in 38 patients with HELLP syndrome were measured. The severity of myocardial damage was dynamically observed in critically ill patients with the change of disease. Results HELLP syndrome group compared with the normal pregnant women group, P <0.01, there is a very significant difference. Troponin I in HELLP syndrome group was significantly higher than that in normal pregnant women. Of the 38 HELLP patients, 8 had troponin I between (0.4-3.9) ng / mL, accounting for 21.05% (8/38) in this group; 30 patients had troponin I between (0.001-0.4) ng / mL, accounting for 78.94% (30/38) in this group. There were 5 cases of troponin I (0.27-0.4) ng / mL, accounting for 13.15% (5/38) in this group. Dynamic observation found that in 8 cases of troponin I (0.4-3.9) ng / mL between, 4 patients with troponin I levels increased with the exacerbations, of which 3 cases of abnormal ECG changes; 3 patients in the ( 0.4-3.9) ng / mL or more, maintained at a high level a few days later, gradually decreased. In the other 5 patients with troponin I level (0.27-0.4) ng / mL, the level of serum troponin I increased from 0.27 ng / mL to 1.4 ng / mL in the dynamic observation and Maintain a few days. Conclusion cTnI can be used as an ideal indicator to judge the damage of cardiomyocytes in HELLP syndrome.