血清肌酸激酶同工酶升高的不稳定型心绞痛的临床特点

The clinical characteristics of unstable angina patients with increased serum CK-MB

目的 探讨血清肌酸激酶同工酶 (CK- MB)升高的不稳定型心绞痛临床特点。方法 根据 CK活性正常但 CK-MB活性升高或正常将病人分为 CK- MB异常组 (n=42 )和正常组 (n=42 ) ,比较两组血清心肌肌钙蛋白 T(c Tn T)阳性发生率、左心室收缩功能、住院期间和一年内心肌梗死、心源性死亡发生率及一年内心绞痛复发率。结果 CK- MB异常组中 CK - MB于症状出现 3～ 4h开始升高 ,12～ 17h达峰值 ,2 0～ 34 h回到正常 ;CK- MB异常组与 CK - MB正常组比较 ,c Tn T阳性率增加 (P<0 .0 1) ,左心室收缩功能差 ,住院期间和一年内心肌梗死、心源性死亡发生率及一年内心绞痛复发率均增高 (P<0 .0 5 )。结论 CK- MB活性升高提示不稳定型心绞痛患者存在心肌损伤和具有较差的预后。

Objective To study the clinical characteristics of unstable angina (UA)patients with increased serum CK-MB. Methods The patients with UA were divided into two groups: In one group (n=42), the CK activities in serum was normal but the CK-MB activities increased, and in another group (n=42), both CK and CK-MB activities in serum were normal. Compare cTnT positive incidence, left ventricular function, myocardial infarction and sudden cardiac death incidence in hospital and within one year and angina re-occurrence incidence within one year in the two groups.Results The serum CK-MB began to increase between 3 and 4 hours after complaint, come to head between 12 and 17 hours, get to back between 20~34 hours in patients with abnormal CK-MB. Furthemore, increased serum cardiac troponin T (P<0.01),decreased left ventricular eject function was found in those patients with increasd CK-MB as compared with normal subjects. The investigation found that the patients with increased CK-MB had a more myocardial infarction and sudden cardic death incidence in-hospital and within one year and had more angina re-occurrence incidence within one year(P<0.05). Conclusion The present study suggest that increased CK-MB in patients with UA demonstrates minor myocardial damage and could predict the bad prognosis.