肌酸激酶-MB蛋白对冠脉再通的心肌梗死定量诊断的意义

Effect of blood serum protein of creatine kinase-MBmass on coronary artery recanalization in myocardial infarction size

目的:探讨血清肌酸激酶-MB蛋白(CK-MBmass)动态变化对冠状动脉(冠脉)再通的心肌梗死定量诊断的意义。方法:动态测定98例急性心肌梗死(AMI)血清CK-MB蛋白的变化,其中静脉溶栓治疗36例和常规治疗62例,根据血清CK-MB蛋白动态变化分为冠脉再通组35例,包括溶栓再通28例和常规治疗自发冠脉再通7例;冠脉未通组63例,包括溶栓未通8例及常规治疗冠脉未通55例。结果:血清CK-MB蛋白、CK-MB活性自发病至恢复正常总的时间,冠脉再通组平均为46.8h,56.3h,冠脉未通组平均为74.6h、85.2h;上升至峰值时间的速率,冠脉再通组平均为0.275h-1,0.255h-1,冠脉未通组平均为0.096h-1、0.087h-1;下降至正常时间的速率,冠脉再通组平均为0.065 h-1,0.058h-1,冠脉未通组平均为0.048h-1、0.041h-1;计算心肌梗死量,冠脉再通组分别平均为32.8CK-MBmass-g、36.2CK-MB-g,冠脉未通组分别平均为48.6CK-MBmass-g、52.6CK-MB-g。结论:根据血清CK-MB蛋白动态变化定量计算心肌梗死显示,冠脉再通患者心肌梗死量明显减少。

Objective： To investigate the role of blood serum protein of creatine kinase isoenzyme MB （CK-MB） in the diagnosis of coronary artery racanalization （CAR） in the patient with acute myocardial infarction （AMI）. Methods： CK-MBmass was measured dynamically in 36 patients treated with thrombolysis and 62 with routine drugs. All patients were divided group（NCAR group）according to dynamic changes of into CAR group and non-coronary artery racanalization CK-MBmass. Results： CAR occurred in 35 patients（28 treated with thrombolysis and 7 with routine drugs）and did not occur in the other 63 patients （8 treated was thronbolysis and 55 with routine drugs）.The total time of CK-MBmass and CK-MB activity were 46.8 hours, 56.3 hours in CAR group,and 74.6 hours, 85.2 hours in NCAR group respectively. The rising rates were 0.275 h^-1,0.255 h^-1 in CAR group,and 0.096 h^-1,0.087h^-1 in NCAR group respectively. The dropping rates of CK-MB mass,CK-MB activity were 0.065 h^-1 ,0.058h^-1 in CAR group and 0.048 h^-1 ,0.041 h^-1 in NCAR group. The average quantity of injured myocardial was 32.8 CK-MBmass-g,36.2 CK-MB-g in CAR group and 48.6 CK- MBmsaa-g,52.6CK-MB-g in NCAR group according to the dynamic changes of CK-MBmass and CK-MB activity. Conclusion： The average quantity gotten according to dynamic changes of CK-MBmass is much less in CAR group.