急性心肌梗死患者血清DNase Ⅰ活性的研究

摘要

目的 研究急性心肌梗死(acute myocardial infarction,AMI)患者血清脱氧核糖核酸酶Ⅰ(deoxyribonuclease Ⅰ,DNase Ⅰ)活性的临床意义.方法 对除外系统性红斑狼疮(systemic lupus erythematosus,SLE)的急性胸痛(疼痛12h以内)入院的冠心病患者(其中AMI患者48例、不稳定性心绞痛患者43例、稳定性心绞痛患者43例)及健康体检者、无心肌缺血证据患者(对照组42列),检测血清DNase Ⅰ的活性及肌酸激酶同工酶MB (creatine kinase-MB,CK-MB)、心肌肌钙蛋白T(cardiac troponin-T,cTn-T)值.结果 AMI患者血清DNase Ⅰ在发病3h内开始升高,6h左右达到高峰,12 h内开始下降,24 h内回到基线水平；CK-MB及cTn-T在发病3～6 h才开始升高.而不稳定性心绞痛、稳定性心绞痛患者和对照组血清DNaseⅠ活性在正常范围,与AMI患者比较差异有统计意义(P＜0.05).结论 血清DNase Ⅰ活性是一个比CK-MB、cTn-T更早、更有特异性诊断AMI的酶标.%Objective To study the clinical significance of serum deoxyribonuclease Ⅰ (Dna-sel) activity in patients with acute myocardial infarction (AMI). Methods The serum Dnase Ⅰ activity and the levels of creatine kinase-MB (CK-MB) and cardiac troponin-T (cTn-T) were determined in coronary heart disease patients who had acute chest pain within 12 hours (except systemic lupus erythematosus) and 42 healthy subjects or patients without evidence of myocardial ischemia (control group). These patients with coronary heart disease were divided into three groups: AMI group(n=48) , unstable angina pectoris group(n = 43) and stable angina pectoris group(n=43). Results Serum Dnase I activity in patients with AMI began to increase within 3 hours after symptom onset and reached a peak, then it began to decline within 12 hours and returned to baseline within 24 hours. Serum CK-MB and cTn-T levels began to increase 3-6 hours after symptom onset. Serum Dnase I activity in unstable angina pectoris group, stable angina pectoris group and control group was maintained in the normal range,and was significantly different from that in AMI group(＜0. 05). Conclusion Serum Dnase Ⅰ activity is a more specific and sensitive index than CK-MB and cTn-T levels for diagnosis of AMI.