肌酸激酶同工酶蛋白诊断急性心肌梗死和冠脉再通的临床价值

Valuation of the CK-MB mass in the early diagnosis of AMI and coronary artery revasualization

目的探讨肌酸激酶同工酶蛋白(CK-MB mass)早期诊断急性心肌梗死(AMI)及冠脉再通的价值。方法118例AMI患者分为常规治疗70例和溶栓治疗48例,不同治疗时间采血检测其CK-MB mass、肌酸激酶同功酶(CK-MB)、肌酸激酶(CK)活性,直至酶学指标降至正常。微粒子酶联免疫分析法测定CK-MB mass,免疫抑制法测定CK-MB活性,速率法测定CK活性。观察AMI冠脉再通和冠脉未通患者心肌标志物出现异常的最早时间、上升至峰值的时间、峰期持续时间、下降至正常的时间。结果AMI冠脉未通组或再通组CK-MB mass与CK-MB活性、CK活性比较出现异常值时间、上升至峰值时间、峰值期持续时间、下降至正常时间明显缩短(P<0.01)。CK-MB mass峰值距AMI发病时间若以<11 h为标准,CK-MB mass诊断冠脉再通的敏感性和特异性均为100%。结论CK-MB mass可早期诊断AMI及AMI冠脉再通。

[Objective] To investigate the value of the CK-MB mass in the early diagnosis of AMI and coronary artery revasualization in AMI. [Methods] The blood samples of one hundred and eighteen patients were drawn at different time after admission until the enzymes dropped to normal in seventy patients who had a routine therapy and forty-eight patients who had a thrombolysis therapy. CK-MB mass was measured by micro-iron enzyme immunoassay method. CK-MB activity was measured by immunodepression method. CK was measured by velocity method. We observed and calculated the time of these enzymatic dynamic changes in the coronary revasualization and unrevasualization patients, such as the earliest abnormal time, from normal to peak＇s time, the continuous peak time, from peak to norm＇s time. [Results] CK-MB mass was shorter than CK-MB and CK activities in the enzymatic dynamic changes in two groups （P〈0.01）. If symptom onset to peak＇s time were less than 11 hours, the sensitivity and specify were 100% in the patients who had coronary artery revasualization. [Conclusion] The CK-MB mass could be a specific marker in the early diagnosis of AMI and judge the coronary artery revasualization in AMI.