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目的:研究血清肌红蛋白(SMB)在急性心肌梗塞时的动态变化特征,做为早期诊断,再通判定指标及与肌酸磷酸激酶(CPK)对此其优越性:在判定再梗塞,梗塞延展和梗塞面积的实用价值。方法:①动物实验:兔36只,雌雄不限,随机分为对照组、结扎冠状动脉前降支;再通再梗塞组,动脉结扎6h 后放开,16h 后重新结扎;梗塞延展组,将结扎部位提高2mm;梗塞面积组,测梗塞不同时间坏死心肌重量。②临床实验:AMI 患者52例,男34例,女18例,平均年龄52.5±10.7岁,设正常人组69例,对照组21例。按设计方案在相应时间内采血检测心肌酶学、SMB、心电图改变,计算心肌坏死重量及相关性。结果:冠状动脉结扎2h 后 SMB 明显升高,4h 阳性率达100%,出现时间早,达峰值快,再通时迅速下降,再梗塞及梗塞延展时出现再次升高,形成第二峰值,SMB 浓度越高,心肌坏死越重,面积越大。结论:SMB 适用于早期诊断 AMI,估价梗塞面积大小,判定再通,再梗塞及梗塞延展,优于 CPK,是一种敏感而特异的生化指标。
Objective: To study the dynamic changes of serum myoglobin (SMB) in acute myocardial infarction. As an early diagnosis, the indexes of judgment and the advantages of creatine phosphokinase (CPK) Extend and infarct size of the practical value. Methods: ①Animal experiment: 36 rabbits were randomly divided into control group and ligation of anterior descending coronary artery. After reperfusion, the rats were re-ligated for 6 hours and then ligated for 6 hours. Ligation site increased 2mm; infarct size group, measured infarct myocardial necrosis at different times weight. ② clinical trials: 52 cases of AMI patients, 34 males and 18 females, mean age 52.5 ± 10.7 years, 69 cases of normal control group and 21 cases of control group. Blood samples were collected for cardiomyopathy, SMB, and electrocardiogram changes at the appropriate time intervals to calculate the weight and the correlation of myocardial necrosis. Results: After 2 hours of ligation of coronary arteries, SMB increased significantly, and the positive rate reached 100% at 4 hours. The appearance time was earlier, reached the peak value rapidly, then rapidly decreased again, and then increased again after infarction and infarction. The higher the concentration, the more severe myocardial necrosis, the larger the area. Conclusion: SMB is suitable for early diagnosis of AMI. It is a sensitive and specific biochemical index to evaluate infarct size, determine recanalization, then infarction and infarct extension, which is superior to CPK.