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目的 观察急性心肌梗塞 (AMI)患者进行自控硬膜外镇痛 (PCEA)治疗期间血清心肌肌钙蛋白 T(c Tn T)的变化。方法 选择 18例 AMI患者随机分成两组 ,A组 (n=9)选择 T2～ 3行常规硬膜外穿刺置管成功后 ,推注 0 .2 5 %丁哌卡因 5 ml,测定阻滞平面为 T1～ 5 观察 30分后接 PCA泵持续治疗 10天。PCEA治疗模式采用 L CP模式。 B组 (n=9)不用 PCEA治疗 ,用止痛药解除疼痛 ,其它治疗两组相同。结果 两组病人发病后血清 c Tn T均升高 ,A组病人治疗后下降明显 ,6天左右降到正常值水平。B组病人血清中高浓度 c Tn T持续时间长 ,第 10天仍高于正常值。结论 PCEA治疗 AIM能明显降低血清 c Tn T浓度 ,提示 PCEA有缓解心肌缺血 ,治疗缺血性心肌病的作用。
Objective To investigate the changes of serum cardiac troponin T (cTn T) during the controlled epidural analgesia (PCEA) in patients with acute myocardial infarction (AMI). Methods 18 patients with acute myocardial infarction (AMI) were randomly divided into two groups. Group A (n = 9) received conventional epidural catheterization (T2 ~ 3), and then received 0.25% bupivacaine The plane for the T1 ~ 5 observed 30 minutes followed by PCA pump for 10 days. PCEA treatment mode using L CP mode. Group B (n = 9) did not receive PCEA treatment, relieved pain with analgesics, and the other treatments were the same for both groups. Results The serum levels of cTnT in both groups increased after the onset of disease. The patients in group A decreased significantly after treatment and were reduced to the normal level in 6 days. Serum concentrations of cTn T in patients in group B persisted for a long time and remained higher than normal on the 10th day. Conclusion PCEA treatment of AIM can significantly reduce serum cTn T concentration, suggesting that PCEA can relieve myocardial ischemia, the treatment of ischemic cardiomyopathy.