急性心肌梗死患者血浆D-二聚体血小板膜糖蛋白Ⅱb/Ⅲa与心肌酶Killp分级的相关意义

Correlaionship of D-dimer and Platelet Glycoprotein Ⅱa/Ⅲb with Myocardial Enzymes and Killp Cardiac Function Grade in Patients with Acute Mycardiac Infarction

目的:探讨急性心肌梗死(AMI)患者血浆D-二聚体(DD)、血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)与心肌酶、Killp分级的相关意义。方法:分别以干化学法、酶联免疫吸附双抗体夹心法测定急性心肌梗塞(AMI)患者50例及正常对照组30例体内血浆DD、GPⅡb/Ⅲa、心肌酶谱,包括肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)含量并记录Killp心功能分级。结果:GPⅡb/Ⅲa、DD与CK-MB呈明显正相关(r=0.410、0.441,P<0.05),GPⅡb/Ⅲa、DD与CK、CTnT无相关关系(P>0.05)。AMI患者血浆GPⅡb/Ⅲa水平,Killp分级Ⅱ级与正常对照组相比,差异有统计学意义(P<0.0125),Killp分级各组间差异无统计学意义(P>0.05)。血浆DD水平,Killp分级Ⅰ、Ⅱ级与正常对照组相比,差异有统计学意义(P<0.0125),各Killp分级组间比较,差异无统计学意义(P>0.0125)。结论:血浆DD、GPⅡb/Ⅲa与判断AMI预后有一定相关,可作为AMI临床观测指标,应用于AMI的诊断与治疗,具有重要意义。

Objective：To explore the relevancy signification of D-dimer（DD） and platelet glycoprotein Ⅱb /Ⅲa（GPⅡb /Ⅲa） with reatine kinase（CK）,creatine kinase isozymes（CK-MB） and troponin T（cTnT） and Killp cardiac function in the patients with v acute myocardial infarction（AMI）.Methods：Plasmas DD 、GPⅡb /Ⅲa 、Creatine kinase（CK）,creatine kinase isozymes（CK-MB） and troponin T（cTnT） from 50 patients with acute myocardial infarction（AMI） and from 30 healthy adults were determined by dry chemical method（DCM）and enzyme-linked immunosorbent adsorption double-antibody sandwich Determination（ELISA）.Killp cardiac function grade were measured in patients with AMI.Results：The level of DD and GPⅡb/Ⅲa were not correlated with CK,cTnT.The concentration of DD and GPⅡb/Ⅲa in all patients with AMI decreased gradually from Killp cardiac function gradeⅣ,Killp cardiac function grade Ⅲ,Killp cardiac function grade Ⅱ,Killp cardiac function gradeⅠto the control group.For the Concentration of DD,the significant difference was found between the control group and the groups of Killp cardiac function grade Ⅱ and Ⅰ,while plasmas DD,no signification was found among four groups.And for the level of GPⅡb/Ⅲa in plasmas,signification was found between the control group and Killp cardiac function grade Ⅱ.There were no signification among the four cardiac funtion grade groups in plasmsa DD.Conclusions：The level of DD and GPⅡb/Ⅲa were closely related with AMI.The level of DD and GPⅡb/Ⅲa in plasmas was correlated with the prognosis of AMI,which may be used as a clinical index in the dignosis and theropy with great significance.