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

摘要

Objective　To investigate the changes in serum myoglobin (Mb) during intravenous thrombolytic therapy with urokinase (UK) in patients with acute myocardial infarction (AMI).Method　Serum Mb was serially measured in 22 cases UK-treated AMI patients 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±198.55ng／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.%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。