心肌5种酶测定的临床价值

Clinical value of determination of myocardial five enzyme

目的 探讨心肌 5酶测定的临床应用价值。方法 对 34 6份血清标本 (急性心肌梗死 132例 ,心肌炎 142例 ,冠心病 72例 )用酶动力学法测定谷草转氨酶 (AST)、乳酸脱氢酶(LDH)、肌酸激酶 (CK)、a -羟丁酸脱氢酶 (α -HBDH)、肌酸激酶同工酶 (CK -MB)。结果 AMI患者发病 4h后 5酶升高 ,2 4hAST、CK、CK -MB、α -HBDH达最高值 ,其中CK达 39.6倍 ,CK -MB 6 .8倍 ;异常值检出率 12hAST 91.7% ,CK 91.7% ,CK -MB 10 0 % ,2 4hLDH 91.7% ,α -HBDH 87.9%。心肌炎儿童较成人心肌 5酶升高明显 ,异常值检出率 :AST儿童 2 0 .4% ,成人 9.1% ;CK -MB儿童 5 0 % ,成人 2 5 % ;冠心病患者心肌 5酶也均升高 ,异常值检出率 :AST5 8.3% ,LDH 33.3% ,CK 41.7% ,α -HBDH 16 .7% ,CK -MB 41.7%。结论 心肌 5酶测定在心脏病诊断、治疗、预后中起重要作用 。

Objective To investigate the clinical value of myocardial five-enzyme determination. Methods In accordance with the enzyme kinetic determination of 346 serums specimens,including 132 acute myocardial infarction(AMI),142 patients with myocarditis and 72 patients with coronary heart disease.Results After the AMI for 4h, the value to five-enzyme increased, after 24h, the values of AST,CK,CK-MB,α-HBDH reached maximum, among which the CK value got as much as 39.9 times and the CK-MB 6.8 times, the abnormal value test and rate of AST was 91.7%,CK91.7%,CK-MB100% within 12h, but within 24h, the rate of LDH is 91.7%,α-HBDH 87.5%.The five-enzyme values in children with myocarditis were clearly higher than those in the adults. The abnormal value test rate:the AST children was 20%,while the adults' 8.3% and the rate in the CK-MB children 50%,while the adults' 25%.The five-enzyme value of the patients with coronary heart disease also rose,the rate of AST 58.3%,LDH 33.3%,CK 41.7%,a-HBDH 16.7% and CK-MB41.7%.Conclusion The serum enzyme determination plays an important role in the diagnosis, treatment and prognosis of myocardial disease,and the increase of serum enzyme is in proportion to the scale of acute myocardial infarction.