自血回输对脊柱手术患者血清cTnⅠ、CK-MB水平的影响

目的]观察自血回输应用于脊柱外科手术时对血清肌钙蛋白Ⅰ（cTnⅠ）、肌酸激酶同工酶（CK-MB）水平的影响.方法]40例ASA Ⅰ～Ⅱ级择期在全麻下行脊柱手术患者随机均分为两组,每组20例.Ⅰ组自体血回输,Ⅱ组输注异体血.记录两组患者术中失血量、异体血输注量并测定全麻诱导插管前（T1）、诱导结束后30 min（T2）、术毕（T3）、术后24 h（T4）患者血清cTnⅠ、CK-MB的水平.结果]与Ⅰ组比较,Ⅱ组异体血输注量增多;Ⅱ组在T3、T4时点cTnⅠ、CK-MB水平增高,其差异有统计学意义（P＜0.05）.结论]自血回输能减少异体血的输注,使心肌酶的水平下降,有利于心肌保护.

Effect of Autoblood Salvage on the Expression of Serum cTnⅠ and CK-MB in Patients Undergoing Spine Surgery

Objective]To observe the effect of autoblood salvage on the expression of serum troponin Ⅰ（cTnⅠ） and creatine kinase（CK-MB） in patients undergoing spine surgery.Methods] A total of 40 ASA Ⅰ ～ Ⅱ patients scheduled for spine surgery under general anesthesia were randomly divided into two groups with 20 cases in each group.Group Ⅰ received autoblood salvage,while group Ⅱ received allogenic blood transfusion.Blood loss and allogenic blood transfusion volume in two groups were recorded.Serum levels of cTnI and CK-MB in patients before tracheal intubation under general anesthesia induction（T1）,30min after induction（T2）,at the end of operation （T3） and 24h after operation（T4） were measured.Results]Compared with group Ⅰ,allogenic blood transfusion volume in group Ⅱ was increased（P ＜0.05）.The levels of cTnⅠ and CK-MB at T3 and T4 were increased,and there was significantly difference（P ＜0.05）.Conclusion]Autoblood salvage can reduce allogenic blood transfusion and decrease the levels of myocardial enzymes,so it is conducive to myocardial protection.