经皮肾镜取石术会导致心肌肌钙蛋白升高吗？
Does percutaneous nephrolithotomy cause elevated cardiac troponins?
作者信息
Shemirani Hassan, Khanjani Reza, Mohammadi-Sichani Mehrdad, Mozafarpour Sarah, Rabbani Majid, Shahabi Javad
机构信息
Associate Professor, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine AND Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
ARYA Atheroscler. 2014 Jan;10(1):41-5.
BACKGROUND
Percutaneous nephrolithotomy is the treatment of choice in large and staghorn renal stones, and myocardial infarction is one the possible complications during and after the surgery. We investigated if renal and skeletal muscle injury, caused by percutaneous nephrolithotomy, can cause elevation in cardiac troponins (cTn).
METHODS
This study was conducted on otherwise healthy patients with renal stone undergoing percutaneous nephrolithotomy. A baseline 12-lead electrocardiogram, echocardiography, and cTn assessment confirmed no cardiac pathology in any patients. Cardiac troponins T (cTnT) and I (cTnI), and also creatine kinase (CK) were assessed before and after surgery.
RESULTS
A total of 55 patients (69.1% males, mean age: 40.5 ± 13.8 year) were included. Serum creatinine level ranged from 0.7 to 1.3 mg/dl (mean = 1.03 ± 0.17). The level of CK was significantly increased by 469.5 ± 201.4 U/l (P < 0.001), and no positive cTnT or cTnI was observed after surgery.
CONCLUSION
The results of the present study showed that renal cell injury, caused by percutaneous nephrolithotomy, is not associated with elevated cardiac troponins. These findings show that increasing troponins in patients undergoing percutaneous nephrolithotomy indicate a cardiovascular pathology.
背景
经皮肾镜取石术是治疗大型和鹿角形肾结石的首选方法，心肌梗死是手术期间及术后可能出现的并发症之一。我们研究了经皮肾镜取石术引起的肾和骨骼肌损伤是否会导致心肌肌钙蛋白（cTn）升高。
方法
本研究针对接受经皮肾镜取石术的健康肾结石患者进行。基线12导联心电图、超声心动图和cTn评估证实所有患者均无心脏病变。术前和术后评估心肌肌钙蛋白T（cTnT）和I（cTnI），以及肌酸激酶（CK）。
结果
共纳入55例患者（男性占69.1%，平均年龄：40.5±13.8岁）。血清肌酐水平在0.7至1.3mg/dl之间（平均=1.03±0.17）。CK水平显著升高469.5±201.4U/l（P<0.001），术后未观察到cTnT或cTnI阳性。
结论
本研究结果表明，经皮肾镜取石术引起的肾细胞损伤与心肌肌钙蛋白升高无关。这些发现表明，经皮肾镜取石术患者肌钙蛋白升高提示存在心血管病变。
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