不稳定型心绞痛患者血清肌酸激酶MM_3/MM_1比值的变化及意义

Change and significance of serum creatine kinase isoenzyme MM sub bands(CKMM 3/MM 1ratio) in patients with unstable angina pectoris

目的 :探讨不稳定型心绞痛 ( UA)患者血清肌酸激酶 ( CK) MM3/ MM1比值的变化及意义。方法 :对 60例 UA、30例稳定型心绞痛 ( SA)和 30例急性心肌梗死 ( AMI)患者在胸痛发作后不同时间采血样 ( 30例对照组仅采血 1次 ) ,采用不连续缓冲体系电泳方法检测 CKMM3/ MM1比值和用速率法测定 CK同工酶 ( CK- MB)和 CK变化。结果 :UA患者按 CKMM3/ MM1比值有 1次≥0 .5为酶学升高的 UA〔 UA( +)〕,否则为酶学正常的 UA〔 UA( - )〕。对照组、SA组和 UA( - )组各指标无显著性差异。UA( +)组中 ,CKMM3/ MM1比值在 0 .5～ 12 h,CK- MB在 2～ 12 h之间高于以上 3组 ( P <0 .0 5 ) ,但 CKMM3/ MM1比值无任何一个超过 1.0 ,且总 CK正常。AMI组 CKMM3/MM1比值在 0 .5～ 12 h,CK- MB在 2～ 12 h之间明显高于 UA( +)组 ( P <0 .0 1)。结论 :部分 UA患者血清 CKMM3/ MM1比值显著升高 ,并早于 CK- MB,为识别 UA患者的高危人群提供了一个简单、可靠。

Objective:To observe the change and significance of serum CKMM 3/MM 1 ratio in patients with unstable angina pectoris(UA).Method:Blood samples were drawn during different time after onset of chest pain in 60 patients with UA, 30 patients with stable angina pectoris (SA) and 30 patients with acute myocardial infarction (AMI). Blood was sampled only once per person in 30 normals. CKMM subbands were detected by the nonserial buffer electrophoresis method,and CK as well as CK MB by velocity method. Student′t test was used for statisical analysis.Result:The patients with UA were divided into two subgroups:the patients with the elevated serum enzyme 〔UA(+)〕 and the patients with the normal serum enzyme 〔UA(-)〕 according to CKMM 3/MM 1 ratio. There was no difference among mean CKMM 3/MM 1 ratio, mean CK MB and mean CK concentration in control,SA and UA(-) group. The patients with UA(+) had higher serum CKMM 3/MM 1 ratio from 0.5 to 12 h and serum CK MB concentration from 2 to 12 h than those with SA and UA(-)(P< 0.05 ). The ratio as well as the concentration were significantly more elevated in patients with AMI than the patients UA(+)(P< 0.01 ) at the same times. All CKMM 3/MM 1 ratio was less than 1.0 and CK within normal range in all groups.Conclusion:Serum CKMM 3/MM 1 ratio is higher and earlier in some patients with UA during attack of chest pain, which provides a simple, reliable and inexpensive method for identification of the high risk patients with UA.