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目的了解经皮球囊肺动脉瓣成形术(PBPV)前后不同时间点血浆心肌钙蛋白-I以及肌酸磷酸激酶同工酶MB(CK-MB)水平的动态变化,以此来评估该治疗方法对患儿心肌细胞的影响。方法2004-01—2005-06在南京市儿童医院接受PBPV的肺动脉瓣狭窄患儿18例,通过酶联免疫吸附法以及免疫抑制法分别测定18例先天性肺动脉瓣狭窄患儿在行球囊扩张治疗不同时间点血浆心肌钙蛋白-I和CK-MB水平。结果术后心肌钙蛋白-I水平明显升高,术后即刻所测心肌钙蛋白-I达到所有时间点的峰值[为(1.34±0.32)μg/L],而1d后绝大多数患儿心肌钙蛋白-I仍维持在术后即刻水平,术后3d已显著下降[为(0.43±0.20)μg/L],与术前[(0.31±0.11)μg/L]相比差异已无显著性。CK-MB于术后即刻也明显升高[为(44.7±8.9)U/L],与术前[为(24.2±7.10)U/L]相比差异有显著性,而术后1d则明显下降,于术后3d降至术前水平[为(27.2±5.3)U/L]。结论经皮球囊肺动脉瓣成形术存在对心肌细胞的损伤作用,但这种损伤是暂时的、可逆的。
Objective To investigate the dynamic changes of plasma cardiac troponin-I and creatine phosphokinase MB (CK-MB) at different time points before and after percutaneous balloon pulmonary valvuloplasty (PBPV) Effects of cardiomyocytes in children. Methods From January 2004 to June 2005, 18 children with pulmonary valve stenosis treated with PBPV in Nanjing Children’s Hospital were enrolled. Eighteen cases of congenital pulmonary valve stenosis were detected by enzyme-linked immunosorbent assay (ELISA) and immunosuppression The levels of plasma cardiac troponin-I and CK-MB at different time points were treated. Results The level of cardiac troponin-I after operation was significantly increased, and the peak value of cardiac troponin-I at all time points was [1.34 ± 0.32] μg / L] immediately after operation. However, after 1 day, The level of calpain-I remained at the level of postoperative immediately after operation, but decreased significantly after 3d ([0.43 ± 0.20] μg / L], which was not significantly different from that before operation [(0.31 ± 0.11) μg / L] . CK-MB was also significantly increased immediately after the operation [(44.7 ± 8.9) U / L] compared with that before operation [(24.2 ± 7.10) U / L], but significantly higher on the 1st postoperative day Decreased to the preoperative level after 3d ([(27.2 ± 5.3) U / L]. Conclusion Percutaneous balloon pulmonary valvuloplasty has the effect on myocardial cell injury, but this injury is temporary and reversible.