Association Study Of Dynamic Variations Of Troponin I With Myocardiac Damage In Craniocerebral Injury Patients

Background Craniocerebral injury is a fetal disease which often leads to disablility death.The morbidity,disability rate and mortality were quite outstanding. Previous studies have suggested that myocardial damage was subsequently followed with craniocerebral injury,especially in those who had severe craniocerebral injury.Objective This study was conducted to observe the dynamic changes of myocardial troponinⅠ,CK-MB as well as the EKG following craniocerebral injury and determine whether there was an association between the severity of craniocerebral injury and the secondary myocardial damage.Methods All the patients were evaluated with GCS within 24 hours after their enrollment and were divided into four groups according to their GCS scores and coma duration and were given 24-hours EKG monitoring.Fasting blood samples were obtained to detect the serum cTnI,CK-MB level at the 1st,3rd,5th,7th and 10th day.Results(1) There are accumulative total 122 patients with secondary myocardial damage among 142 enrolled craniocerebral injury patients and the accumulative rage is 17.18%.There is 10 patients have secondary myocardial damage among 87 low-grade head injury patients(GCS scores 9 or higher,the accumulative rate is 4.78%),while the number in those 55 severe head injury patients(GCS scores less than 9) is 112,the accumulative rate is 40.73%.The difference of the incidence of secondary myocardial damage between the low-grade and severe head injury patients achieved statistical significant level(P＜0.05).(2) The accumulative positive rate of serum cTnI are:2.98%for group A,6.50%for group B,41.33%for group C and 53.60% for group D.The difference among four group has statistical significance(P＜0.01) and there is a significant association between the degree of patients condition and the serum cTnI positive rate(P＜0.01).The summary positive rate of CK-MB are: 2.13%for group A,3.00%for group B,22.67%for group C and 40.00%for group D.The difference among the four groups also achieves statistical significant level (P＜0.01) and we can also see a significant association between the CK-MB positive rate and the craniocerebral injury patients condition(P＜0.01).The accumulative abnormal rate among the four groups are 0.43%,3.50%,47.33%and 66.40%.We also can find a significant difference among these four groups and a significant association between the EKG abnormal rate and the severity of head injury(P＜0.01). (3) Severe craniocerebral injury patients are usually followed by secondary myocardial damage.The positive rate of serum cTnI and CK-MB and the abnormal rate of EKG often increased after the craniocerebral injury taken place and achieve the top at the 5th to 7th day.However,the rates usually have decreased after this time windows.Conclusion Our data suggest that the severe craniocerebral injury patients usually have secondary myocardial damage.There is a significant association between the positive rate of secondary myocardial damage,serum cTnI, CK-MB,EKG abnormality and the severity of craniocerebral injury.The more severe the craniocerebral injury,the greater risk of developing the secondry the craniocerebral injury took place.