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目的通过观察胸部创伤所致心肌挫伤患者采用重组人生长激素(GH)治疗前、后血清心脏型脂肪酸结合蛋白(h-FABP)的变化,探讨临床疗效及心肌挫伤的早期诊断。方法对63例胸部创伤所致心肌挫伤患者采用重组GH治疗,治疗前、后进行血清h-FABP、肌酸磷酸激酶同功酶(CK-MB)检测及普通心电图(ECG)检查。结果 (1)胸部创伤合并心肌挫伤患者治疗前h-FABP、CK-MB水平高于对照组,差异有统计学意义(P<0.01)。治疗后水平下降,与对照组相比差异无统计学意义(P>0.05),治疗前、后相比差异有统计学意义(P<0.01)。(2)治疗前胸部创伤合并心肌挫伤患者血清h-FABP的阳性率(38.9%)高于血清CK-MB的阳性率(27.8%),也高于ECG(18.5%)的异常率,差异有统计学意义(P<0.01)。(3)胸部创伤合并心肌挫伤患者经重组人GH治疗后均治愈,无死亡病例。结论重组人GH对胸部创伤所致的心肌挫伤具有治疗作用,血清h-FABP定量测定是早期诊断胸部创伤合并心肌挫伤的一项指标,比CK-MB和ECG具有更高的敏感性。
Objective To observe the changes of serum cardiac fatty acid binding protein (h-FABP) in patients with myocardial contusion after thoracic trauma by using recombinant human growth hormone (GH) before and after treatment, and to explore the clinical efficacy and early diagnosis of myocardial contusion. Methods Sixty-three patients with myocardial contusion caused by thoracic trauma were treated with recombinant GH. Serum h-FABP, creatine phosphokinase isoenzyme (CK-MB) and common electrocardiogram (ECG) were measured before and after treatment. Results (1) The levels of h-FABP and CK-MB in patients with chest trauma combined with myocardial contusion before treatment were significantly higher than those in control group (P <0.01). There was no significant difference between the two groups after treatment (P> 0.05). There was significant difference between before and after treatment (P <0.01). (2) The positive rate of serum h-FABP in patients with chest trauma with myocardial contusion (38.9%) before treatment was higher than that of serum CK-MB (27.8%) and higher than that of ECG (18.5%) Statistical significance (P <0.01). (3) Patients with chest trauma with myocardial contusion were cured after treatment with recombinant human GH without any deaths. Conclusions Recombinant human GH has a therapeutic effect on myocardial contusion caused by thoracic trauma. Quantitative determination of serum h-FABP is an indicator of early diagnosis of chest trauma with myocardial contusion, which is more sensitive than CK-MB and ECG.