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目的探讨线粒体天门冬氨酸转氨酶同工酶(m-A ST)在急性心肌梗死(AM I)患者血清的变化及其临床意义。方法用全自动生化分析仪测定了19例AM I患者血清m-A ST活性,同时观察其它4种心肌酶A ST、CK、CK-M B、LDH动态变化。结果AM I患者,发病6 h血清m-A ST即升高,与对照组相比有极显著差异,P<0.001。12 h迅速升高,24 h达峰值(256.5±69.5 IU/L),此后,逐渐下降,120 h时基本正常,与对照组相比无显著差异,P>0.05。m-A ST升高的幅度差别较大,6h m-A ST升高幅度略低于CK-M B、A ST;12 h迅速升高,是正常的16.2倍;48 h达最高,是正常的21.9倍;随后迅速下降,120 h时是正常的1.3倍,升高曲线与CK-M B相当,比A ST、CK及LDH敏感。与A ST、CK、CK-M B、LDH的异常检出率进行比较,发病6 h异常检出率依次为CK-M B>CK>A ST>m-A ST>LDH,24 h内不断上升,其中以m-A ST与CK-M B异常检出率最高,达100%,CK、A ST次之,为89.5%和84.2%,LDH较低,为73.6%。48 h后检出率逐渐下降,下降速度是A ST 3.9倍,是CK 2.7倍,CK-M B 1.2倍,LDH 5.1倍。结论检测并动态观察m-A ST酶活性,可作为诊断AM I并评价疗效、判断预后的一项新的生化指标。
Objective To investigate the changes of mitochondrial aspartate aminotransferase isoenzyme (m-A ST) in patients with acute myocardial infarction (AMI) and its clinical significance. Methods Serum m-Ast activity was measured in 19 patients with AMI by automatic biochemical analyzer. The dynamic changes of A, CK, CK-M B and LDH were also observed. Results In AM I patients, the serum level of mA ST increased 6 h after onset with a significant difference compared with the control group (P <0.001.12 h), and peaked at 24 h (256.5 ± 69.5 IU / L) Gradually decreased, basically normal at 120 h, no significant difference compared with the control group, P> 0.05. The amplitudes of mA ST varied greatly. The increase amplitude of mA ST was slightly lower than that of CK-M B and A ST at 6h, which was 16.2 times of normal at 12 h, 21.9 times at 48 h, Followed by rapid decline, 1.3-fold normal at 120 h, comparable to CK-M B and sensitive to A ST, CK, and LDH. Compared with the detection rate of abnormalities of A ST, CK, CK-M B and LDH, the anomaly detection rates of 6 h after onset were CK-M B> CK> A ST> mA ST> Among them, the highest detection rate of mA ST and CK-M B was 100%, followed by CK and A ST was 89.5% and 84.2%, respectively, and LDH was low at 73.6%. After 48 h, the detection rate decreased gradually. The decreasing speed was 3.9 times of A ST, 2.7 times of CK, 1.2 times of CK-M B and 5.1 times of LDH. Conclusions The detection and dynamic observation of m-Astase activity can be used as a new biochemical indicator for the diagnosis of AMI and evaluate the curative effect and prognosis.