目的：研究射频导管消融术(RFCA)患者术前及术后不同时间血清心肌肌钙蛋白T(cTnT)，肌酸激酶(CK)，肌酸激酶同工酶(CK-MB)及天冬氨酸转氨酶(AST)浓度变化及与RFCA诸因素的关系。探讨RFCA对心肌组织损伤程度。

方法：采用ELISA一步夹心免疫测定法，分别测定40例阵发性室上性心动过速(PSVT)患者RFCA术前及术后即刻，6小时，12小时，24小时和25例正常人血清cTnT以及上述心肌酶浓度。

结果：RFCA患者cTnT，CK，CK-MB,AST均于术后即刻升高，术后6小时达到峰值，12小时下降，24小时除CK外，其余均恢复正常。经相关分析表明cTnT活性变化的峰值升高程度与消融时间，平均功率及累计能量均无线性关系(r=0.33,r=0.25,r=0.29,P值均大于0.05),而与消融靶点个数高度正相关(r=0.81,P＜0.001),与消融次数也有显著关系(r=0.51,P＜0.01)。

结论：RDCA对心肌组织确有不同程度的损伤，但持续时间短，损伤轻，恢复快。提示RFCA系安全有效的治疗快速心律失常的方法。测定cTnT可作为临床判断RFCA对心肌损伤的监控指标。

Study about Contents of Cardiac Troponin T, Some Myocardial Enzymes before and after radiofrequency Catheter Ablation (Abstract)

Department of cardiology, Affiliated Hospital of Ningxia Medical College, Yinchuan (750001), ningxia

sha Yong, Chen Shulan, Jia Saobin, et al.

objective: To study the relationship between changes of serum cardiac troponin T (cTnT), creatine kinase(CK) and its MB (CK-MB), aspartate aminotransferase (AST) levels and myocardial injury in patients with permanent superaventricular tachycardia (PSVT) undergoing radiofrequency catheter ablation (RFCA).

Methods: the levels of above mentioned enzymes (substances) were measured before, immediately after ablation and every 6 hours thereafter for 24 hours to detect myocardial injury in 40 patients with PSVT and 25 age-matched normal subjects.

Results: the levels of all the substances of the RFCA patients escalated immediately after ablation and reached the peak by 6 h, and then gradually decreased from 12 h, returned to normal by 24 h with the exception of CK. Compared with the levels of the patients before ablation and those of the controls, the excalating was significant. The analysis of linear correlation showed that the levels of serium cTnT positively correlated with the number of ablation sites (r=0.81, p＜0.001) and ablation radiofrenquency (r=0.51, p＜0.01); not correlated with ablation time, average power and accumulative energy (r=0.03,r=0.25, r=0.29, p＞0.05).

Conclusion: it was concluded that RFCA for PSVT patients indeed caused some miner myocardial injury, the measurement of cTnT might be useful to detect myocardial injury in ablation patients with PSVT.