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目的:评价CK-MB和cTnI对严重创伤后继发性心肌损伤的诊断价值。探讨低血容量性休克对严重创伤后继发性心肌损伤的影响。方法回顾性分析104例严重创伤患者,依据是否并发低血容量性休克分为休克组(56例)与对照组(48例),入院24小时内检测血清CK-MB及cTnI,观察严重创伤后CK-MB及cTnI的变化情况并进行组间对比。结果两组入选患者在性别比、年龄、ISS评分方面相比差异无统计学意义(P>0.05)。104例患者中,90例(86.5%)出现了CK-MB升高,其中休克组54例(96.4%),对照组36例(75.0%)。38例(36.5%)出现了cTnI升高,其中休克组34例(60.7%),对照组4例(8.3%)。定量比较显示,休克组及对照组CK-MB中位数(39ng/mL vs 13.8ng/mL)相比,差异有统计学意义(P<0.001)。休克组及对照组cTnI中位数(0.31ng/mL vs 0.01ng/mL)相比,差异有统计学意义(P0.05). The median CK-MB level of the shock group was 39 ng/ml, significantly higher than that of the control group (13.8 ng/ml,P<0.001). The median cTnI of the shock group was 0.31 ng/ml, significantly higher than that of the control group (0.01 ng/ml,P<0.001). Conclusion Increased cTnI level is a sensitive index for TISCI and ACES in patients with severe trauma. Hypovolemic shock may be an important risk factor for TISCI.