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目的:探讨血清肌钙蛋白I(cTnI)对创伤性休克家兔心肌损伤的诊断价值。方法:按Lamson’s法建立创伤性休克家兔模型。随机将16只大白兔分成两组(对照组和休克组)每组8只。检测休克前、休克后0.5h、1.5h、3h和4h5个时间点血清cTnI的水平,观察创伤性休克家兔在休克过程中cTnI的动态变化。并于4h后打开家兔胸腔,取部分心肌组织制成标本,电镜观察心肌细胞结构的变化。结果:休克组家兔休克后各时间段血清cTnI明显高于对照组(P<0.05或P<0.01)。电镜下可见心肌肌丝元明显收缩,肌浆网扩张,部分肌丝断裂、溶解、线粒体聚集,间质血管腔内炎性细胞浸润等结构的变化。结论:创伤性休克兔存在心肌损伤,cTnI是判断创伤性休克兔心肌损伤灵敏可靠的指标。
Objective: To investigate the diagnostic value of serum troponin I (cTnI) in myocardial injury of traumatic shock in rabbits. Methods: Rabbit model of traumatic shock was established by Lamson ’s method. Sixteen rabbits were randomly divided into two groups (control group and shock group). The level of serum cTnI was measured at 5h, 1.5h, 3h and 4h after shock, and the dynamic changes of cTnI in traumatic shock rabbits were observed. After 4h, the rabbit’s thoracic cavity was opened and some of the myocardium was taken to make specimens. The changes of myocardial cell structure were observed by electron microscope. Results: The serum cTnI in shock group was significantly higher than that in control group after shock (P <0.05 or P <0.01). Electron microscopy showed a significant contraction of myocardial filament, sarcoplasmic reticulum dilatation, part of the myofilament rupture, dissolution, mitochondria aggregation, interstitial vascular inflammatory cell infiltration and other structural changes. CONCLUSION: Myocardial injury exists in traumatic shock rabbits. CTnI is a sensitive and reliable indicator of myocardial injury in traumatic shock rabbits.