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目的研究检测生化标志物血清肌红蛋白(MYO)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)和C-反应蛋白(CRP)对急性心肌梗死溶栓冠脉再通的早期诊断价值。方法MYO、cTnI、CK-MB使用酶联免疫分析法、CRP使用激光散射比浊法测定127例急性心肌梗死患者溶栓治疗前后MYO、cTnI、CK-MB和CRP浓度和时间的变化,分析急性心肌梗死患者溶栓再通组(83例)和溶栓未通组(44例)上述指标的连续、动态演变。结果急性心肌梗死溶栓再通组MYO、cTnI、CK-MB和CRP达到峰值浓度的时间较未通组明显提前(P<0.01),其中MYO较cTnI、CK-MB和CRP峰值时间出现更早,分别为(6.1±2.4)h、(13.8±3.5)h、(14.4±3.8)h和(25.2±5.7)h(P<0.01);再通组MYO和CRP峰值浓度明显高于未通组(P<0.01);MYO、cTnI、CK-MB和CRP对判断冠脉再通的敏感性、特异性、预测值差异无统计学意义(P>0.05)。结论血清MYO、cTnI、CK-MB和CRP可以较好地预测急性心肌梗死患者溶栓再通,其中MYO较cTnI、CK-MB和CRP能更早期判断冠状动脉是否再灌注;CRP对溶栓后冠脉再通的判断也有积极的参考意义。
Objective To investigate the effect of serum myoglobin (MYO), troponin I (cTnI), creatine kinase (CK-MB) and C-reactive protein (CRP) on thrombolysis of coronary artery in acute myocardial infarction The value of early diagnosis. The changes of MYO, cTnI, CK-MB and CRP concentration and time before and after thrombolysis in 127 patients with acute myocardial infarction were measured by laser light scattering turbidimetry. The changes of the concentration and time of MYO, cTnI, CK- The continuous and dynamic evolution of the above indexes in thrombolytic group (83 cases) and failed thrombolysis group (44 cases) in patients with myocardial infarction. Results The peak time of peak MYO, cTnI, CK-MB and CRP in thrombolytic group was significantly earlier than that of the control group (P <0.01), and the peak of MYO was earlier than that of cTnI, CK-MB and CRP (6.1 ± 2.4) h, (13.8 ± 3.5) h, (14.4 ± 3.8) h and (25.2 ± 5.7) h (P <0.01), respectively. The peak concentrations of MYO and CRP in the recanalization group were significantly higher than those in the unreceptive group (P <0.01). The sensitivity, specificity and predictive value of MYO, cTnI, CK-MB and CRP in predicting coronary recanalization were not statistically different (P> 0.05). Conclusion Serum MYO, cTnI, CK-MB and CRP can predict thrombolytic recanalization in acute myocardial infarction patients, and MYO can predict coronary artery reperfusion earlier than cTnI, CK-MB and CRP. Coronary recanalization also has a positive reference value.