急性心肌梗死患者血清m-AST的变化及意义

The Changes and Diagnostic Value of Serum m-AST Level in Patients with Acute Myocardial Infarction

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 discuss the changes of serum m-AST level and their clinical implication in patients with acute myocardial infarction （AMI）. Methods m-AST level of serum were detected in 19 cases of patients with AMI. At the same time,the dynamic changes of serum AST,CK,CK-MB and LDH were also measured. Results The level of serum m-AST increased within 6 hours and it was significantly higher than in control group （P〈0. 001）. It increased rapidly at 12th hours and reached its peak at 24th hour （256.5±69.5 IU/L）,after that,the serum level of m-AST decreased gradually and reached normal at 120th hour,at this point, which has no significant difference when compared with control （P〉0. 05）. The serum level of m-AST increased in different extent at different time,at 6th hour,which lower than CK-MB and AST but increased rapidly at 12th hour and reached a degree 16.2 times as normal, which reached its peak at 48th hour （21.9 times as normal） and then decreased rapidly, reached 1.3 times as normal at 120th hour. Compared with CK-MB, the serum m-AST changing is sensitive than AST, CK and LDH. Compared with AST,CK,CK-MB and LDH , the abnor- mal detection rate in 6 hours decreased as follows CK-MB〉 CK〉 AST〉 m-AST〉 LDH and increased steadily in 24 hours. Among them, m-AST and CK-MB are the most easily detected,accounting for 100% ,while CK and AST are the second with 89.5% and 84.2%,LDH is lower with 73.6%. The detection rate decreased after 48th hour, the decreased rate were 3.9 times as AST, 2.7 times as CK and 1.2 times as CK-MB and 5.1 times as LDH. Conclusion Detection of dynamic changes of serum m-AST level can be as effective indicator to diagnose AMI and value the curative effect and the prognosis of AMI.