肌钙蛋白T动态监测对急性心肌梗塞溶栓疗效的判断价值

DIAGNOSTIC VAL UE OF SERUM Tn T MEASUREMENT IN ACUTE MYOCARDIAL INFARCTION PATIENT WITH THROM- BOL YSISTHERAPY

1目的 探讨急性心肌梗塞 (AMI)溶栓后冠状动脉再通血清肌钙蛋白 T(Tn T)释放动力学变化。 2方法 用酶联免疫测定法对 30例溶栓和 32例未溶栓治疗的 AMI病人血清 Tn T进行了动态监测。 3结果 溶栓组 30例 ,冠状动脉再通 2 2例 ,血清 Tn T释放呈双峰曲线 ;溶栓未通 8例 ,血清 Tn T呈单峰曲线。对照组 32例 ,血清 Tn T释放呈双峰曲线 7例 ,单峰曲线 2 5例。两组双峰曲线比例比较 ,差异有极显著性 (χ2 =16 .47,P<0 .0 1)。溶栓后冠状动脉再通者血清 Tn T早期峰值与后期峰值出现的时间分别为 16 .2± 5 .2 h和 85 .3± 16 .4h,其 Tn T释放16 / 36 h比值 >1,第 1峰与第 2峰的比值 >1.对照组病人 (除少数血栓自溶外 ) Tn T释放呈单峰曲线 ,其峰值时间为 6 7.6± 18.9h,16 / 36 h值 <1,第 1峰与第 2峰比值 <1.4结论 溶栓治疗病人 Tn T释放呈双峰曲线 ,16 / 36 h比值 >1,第 1峰与第 2峰比值 >1,可望作为

Objective This study was designed to investigate the change of thrombolysis on the kinetics of troponin T (Tn T) release in acute myocardial infarction (AMI) . Methods Serum Tn T level was measured in 30 AMI patients with throm- bolytic therapy and32 AMI patients without thrombolytic therapy by ELISA method. Results The curves of serum Tn T con- centration in 2 2 cases who had successful reperfusion were biphasic and the curves of 8AMI patients who had not successful reper- fusion were monophasic.Among 32 AMI patients without thrombolytic therapy,7patients were biphasic and 2 5 cases were monophasic.The biophasic rate between the patients with and without thrombolysis therapy was significantly different(χ2 = 16 .47,P<0 .0 1) .The appearance time of first peak value and the second peak value were 16 .2± 5 .2 h and 85 .3± 16 .4h in the reperfusion cases,the ratio of Tn T concentration at16 /36 h was greater than1.The ratio of first peak to second peak>1.The curve of serum Tn T concentration in patients who were not treated with thrombolysis was monophasic,the appearance time of peak value was6 1.6± 18.9h,the ratio of Tn T concentration at16 /36 h was below1.The ratio of first peak to second peak<1. Con- clusion The curve of serum Tn T concentration in thrombolysis therapy group was biphasic.The ratio 16 /36 h>1,the ratio of first peak valve to second peak value>1.So the measurementof serum Tn T level could be used as diagnostic index fordeterm ining reperfusion in AMI patients.