尿激酶溶栓治疗急性心肌梗塞过程中血清肌红蛋白的变化

Changes in serum myoglobin after thrombolytic treatment of acute myocardial infarction with urokinase

目的：检测急性心肌梗塞患者尿激酶溶栓治疗过程中血清肌红蛋白（ｍｙｏｇｌｏｂｉｎ， Ｍｂ）的动态变化。方法：应用ＥＬＩＳＡ方法检测血清Ｍｂ的水平。结果：再灌注组血清Ｍｂ的峰浓度（６１９．５９±１９８．５５ｎｇ／ｍｌ）显著高于未再灌注组（４８７．３１±６０．８７ｎｇ／ｍｌ），而且再灌注组较未再灌注组血清Ｍｂ达峰时间明显提前（１９２ｍｉｎ对４８０ｍｉｎ，Ｐ＜０．０１），再灌注组Ｍｂ的２小时出现率（Ｍｂ２／Ｍｂ０）较未再灌注组也显著增高（４．２４对２．１２，Ｐ＜０．０１）。结论：血清Ｍｂ值在尿激酶溶栓治疗冠脉再灌注后早期上升、快速达峰，可以作为一种可靠而简便的判断ＡＭＩ再灌注治疗成功与否的指标。

Objective To investigate the changes in serum myoglobin (Mb) during intravenous thrombolytic therapy with unkinase (UK) in patients with acute myocardial infarction (AMI). Method Serum Mb was serially measured in 22 cases UK - treated AMI pa- tients and 22 cases AMI patients treated with conservative therapy before and 1, 2, 4, 8, 12, 14, 15, 18 and 24 hours after treatment. Peak values and the median time to peak value of Mb were compared between reperfusion group and non - reperfusion group. Results Peak value of serum Mb in reperfusion group was 619.59±198.55mg/ml, significantly higher than that in non - reperfusion group(487.31± 60.87ng/ml).Time to peak value of Mb in reperfusion group was shorter than that in non - reperfusion group (192min vs 480min, P< 0.01). Mb appearance rate calculated as concentration at 2 hours divided by baseline values (Mb2/Mb0) was also higher in reperfusion group than in non - reperfusion group (4. 24 vs 2. 12, P <0.01). Conclusion An early rise and a peak in serum myoglobin values seems to be a reliable and simple noninvasive indicator of successful reperfusion therapy by using UK.