肌红蛋白在急性冠脉综合征诊断和治疗中的价值

The value of myoglobin in diagnosis and treatment of acute coronary syndrome

目的:探讨血浆中肌红蛋白在急性冠脉综合征早期诊断和溶栓效果中的价值。方法:检测胸痛患者和健康者肌红蛋白(Myo)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)的血浆含量。比较三者在不同时间点的灵敏度。观察Myo在溶栓前后区别,比较其与CK-MB对溶栓再通效果。结果:胸痛组所测各值均高于对照组(P<0.05)。胸痛组Myo与对照组有显著差异(P<0.05),胸痛组CK-MB与对照组无明显差异(P>0.05)。Myo在发病0 h～4 h达到峰值,提前于其他指标(P<0.01)。回落到正常值的时间短于其他指标。溶栓术后,血浆中Myo含量明显升高,酶峰出现在5.3 h,比CK-MB有显著性提前(P<0.01)。结论:Myo在胸痛发作1 d内确定急性冠脉综合征较cTnI和CK-MB灵敏度高。其含量可初步推测冠状动脉病变的严重程度和溶栓再通疗效的观察。

Objective： To explore the clinical value of myoglobin in early diagnosis of acute coronary syndrome and monitoring effect of thrombolysis.＇ Methods： The contents of Myo, cTnI and CK - MB in plasma were measured in patients group and healthy people group, and the sensitivity were observed at different time points. The Myo level was observed before and after thrombolysis to detect the thrombolytic effect. Results： The concentration of Myo, cT- nI and CK - MB in chest pain patients were higher than those in the healthy controls （P 〈 0.05 ）. Myoglobin level reached the peak in 4 hours after incidence, more advanced than cTnI and CK - MB （ P 〈 0.01 ）, and the peaking time and falling time of myoglobin were shorter than others. The level of myoglobin will rise to the peak at 5.3 h after thrombolysis, earlier than that of CK - MB （ P 〈 0.01 ）. Conclusion： Myoglobin was a sensitive and accurate index within 1 day after chest pain occurrence. Myoglobin can speculate the grade of coronary artery disease and effect of thrombolysis.