【摘要】 目的 观察老年高血压病人围手术期心肌肌钙蛋白Ⅰ(cTnI)的动态变化并评价其心肌损伤程度。方法 40例60岁以上高血压择期手术病人，根据收缩压(SBP)分为A组(SBP： 146±18mmHg, 14例)、B组(SBP： 167±16mmHg,13例)、C组(SBP： 188±26mmHg,13例)。于麻醉前、气管插管后、手术开始1h、气管拔管即刻、术后6h、术后24h抽取肘部静脉血,用免疫化学发光法测定血清cTnI水平。记录麻醉前、诱导后、气管插管后、气管拔管后SBP、心率(HR)及术中心电图(ECG)的变化。结果 A组术后6h、24hcTnI均有所增高，但与术前比较差异无显著性；B组于气管拔管后、C组于手术1h后开始升高、术后6～24h达高峰，与术前及A组相比差异有显著性(P<0.01)。B组和C组术中血压变化较A组显著(P<0.01)。结论 老年高血压病人围手术期cTnI可明显升高。术前高血压程度越高，围手术期cTnI升高越显著，其心肌损伤也越严重。

    【关键词】 心肌肌钙蛋白Ⅰ；高血压；围手术期

    Perioperative release of cardiac troponin I in elderly patients with hypertension

    LIU Hui, XIE Hai-yu, XU Jian-she, et al.

    The People's Hosptial,Tianmen City,Hubei 431700，China

    【Abstract】 Objective To investigate release of cardiac troponin I (cTnI) in elderly patients with hypertension during surgery and evaluate myocardial ischemic injury. Methods 40 patients with hypertension, more than 60 years, scheduled to elective surgery under general anesthesia, were allocated into three groups： A group(SBP： 146±18 mmHg, n=14), B group(SBP： 167±16 mmHg, n=13), C group(SBP： 188±26 mmHg, n=13). Venous blood samples were taken at various times during perioperation for determination of cTnI. SBP, HR, and changes of ECG were recorded. Results cTnI in A group increased at 6 h, 24h after surgery, but no significantly difference compared with that before surgery. cTnI increased in B group after extubation and in C group at 1h after surgery was performed, and reached the peak from 6 h to 24 h after surgery, and were significantly higher than that before surgery and in A group. Changes of blood pressure in group B and group C were more significant than that in group A. Conclusions cTnI in elderly patients with hypertension may increase during perioperation. There is positive correlation between hypertension and cTnI or ischemic myocardial injury. ......