常见血清酶测定在急性心肌梗塞诊断中的应用

Application of Cardiac Enzymes in Diagnosis of Acute Myocardiac Infarction

对１９９２ 年６ 月至１９９３ 年４ 月入院诊断为急性心肌梗塞（ＡＭＩ） 患者在发病后即时至４８ ｈ 分三个阶段进行连续取血样测定４ 种血清酶（ＡＳＴ、ＣＫ、ＬＤＨ、ＣＫＭＢ） 的含量， 且与心电图作比较． 结果表明， 在ＡＭＩ过程中酶异常检出率最高可达到９０ ％ （ＡＳＴ、ＣＫＭＢ） ， 最低为７０ ％ （ＬＤＨ） ． 若以异常Ｑ 波为ＡＭＩ确诊， 其不能检出率为４０ ％ ； 提示在ＡＭＩ早期作血清酶检测有助于进一步确诊及减少漏诊率． 若ＡＭＩ患者已下降的ＣＫＭＢ 再度上升， 提示可能有新的梗死灶发生； ＡＭＩ患者在发病６ ｈ 内， 血清酶显著升高， 提示预后不佳．

The serum cardiac enzymes in 30 cases of patients with acute myocardiac infarction(AMI) were studied. From the onset to 48 hours of AMI, the sera were collected in three different stages. By comparing with electrocardiogram respectively, the activities of AST,CK, LDH and CK MB were measured. The results revealed that the highest positive rate of serum cardiac enzymes were 90%(AST,CK MB), and the lowest positive rate was 70%(LDH).By using Q wave as a confirmatory index of AMI, the negative rate of cardiac enzymes was 40%. The early detection of increasing cardiac enzymes could indicate the presence of AMI. An increasing of CK MB in patients with AMI indicated a possible new infarction occurred. A patient had increasing of cardiac enzymes within 6 hours of AMI might have a poor prognosis.