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目的探讨血清肌红蛋白(Mb)、肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)对急性心肌梗死溶栓冠脉再通的早期诊断价值。方法应用酶联免疫分析法测定106例急性心肌梗死患者溶栓治疗后Mb、cTnI、CK-MB浓度的变化,分析急性心肌梗死患者溶栓再通组(73例)和溶栓未通组(33例)上述指标的变化。结果急性心肌梗死溶栓再通组Mb、cTnI和CK-MB达到峰值浓度的时间较未通组明显提前(P<0.05),其中Mb较cTnI、CK-MB峰值出现更早,分别为(5.9±2.5)h、(14.5±3.2)h和(14.8±3.9)h(P<0.01);Mb、cTnI和CK-MB对判断冠脉再通的敏感性、特异性、预测值无显著性差异(P>0.05)。结论血清Mb、cTnI和CK-MB可以较好地预测急性心肌梗死患者溶栓再通,其中Mb较cTnI、CK-MB能更早的判定冠状动脉是否再灌注。
Objective To investigate the value of serum myoglobin (Mb), troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) in the early diagnosis of recanalization of thrombolytic coronary artery in acute myocardial infarction. Methods The concentrations of Mb, cTnI and CK-MB in 106 patients with acute myocardial infarction after thrombolysis were measured by enzyme-linked immunosorbent assay (ELISA). The levels of Mb, cTnI and CK-MB in patients with acute myocardial infarction were analyzed retrospectively. 33 cases) changes in the above indicators. Results Compared with the control group, the peak time of Mb, cTnI and CK-MB in thrombolytic group was significantly higher than that of control group (P <0.05), Mb was earlier than that of cTnI and CK-MB, ± 2.5) h, (14.5 ± 3.2) h and (14.8 ± 3.9) h respectively (P <0.01). The sensitivity, specificity and predictive value of Mb, cTnI and CK-MB in judging coronary recanalization were not significantly different (P> 0.05). Conclusions Serum Mb, cTnI and CK-MB can be used to predict recanalization of thrombolytic therapy in patients with acute myocardial infarction. Mb can determine coronary artery reperfusion earlier than cTnI and CK-MB.