急性心肌梗塞肌红蛋白检测的诊断价值  

Diagnostic Value of Myoglobin Measurement in Acute Myocardial Infarction

作　　者：尹航[1] 黄峻[1] 杨春梅[1] 孔祥清[1] 杨志健[1] 马根山[1] 

机构地区：[1]南京医科大学第一附属医院心脏科

出　　处：《南京医科大学学报（自然科学版）》1997年第1期5-8,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科委自然科学基金

摘　　要：测定７８例血清肌红蛋白（Ｍｂ）浓度，其中３３例急性心肌梗塞（ＡＭＩ）急性期入院，最早在起病后１．５小时升高，２１例在冠脉再通治疗后（４６．７±１７．３）分钟出现升高的峰值，平均为（８８９．９±４７．３）μｇ／Ｌ，比再灌注前升高６５．５％，Ｍｂ异常升高持续（３７．３±６．８）小时。另观察２０例不稳定性心绞痛（ＵＡＰ）患者，疼痛发作期和间歇期Ｍｂ分别为（５６．３±２１．６）μｇ／Ｌ和（４１．６±２．３）μｇ／Ｌ。２５例运动试验受试对象的结果：运动前后分别为（３３．７±１２．４）μｇ／Ｌ和（４６．３±２１．３）μｇ／Ｌ。该２组与ＡＭＩ组入院Ｍｂ相比，差异均显著（Ｐ＜０．０５）。ＡＭＩ患者Ｍｂ诊断的敏感度为１００％，特异度为８４％，阳性预测值为８９．２％，阴性预测值为１００％。本研究表明，Ｍｂ是ＡＭＩ急性期诊断很敏感且较特异性的生化指标，有助于与ＵＡＰ相鉴别。We measured serum myoglobin (Mb) in 33 acute myocardial infarction (AMI) patients who were admitted at the acute stage. The earlist rise was 1.5 hours after the onset. The peak value which was 889.9±47.3 μg/L and rose 65.5% over that of administration occured at 47.6±17.3 min after reperfusion in 21 cases. The rise of Mb lasted 37.3±6.8 hours.The Mb concentrations of onset and rest stages in 20 patients of unstable angina pectoris (UAP) were 56.3±21.6 μg/L and 41.6±12.3 μg/L respectively. We also measured Mb in 25 subjects who took exercise tests, the concentrations before and after exercise were 33.7±12.4 μg/L and 46.3±21.3 μg/L respectively. The differences were significant when these 2 groups were compared with AMI group respectively ( P <0.05). The sensitivity、 speciality、 positive estimation and negative estimation for Mb diagnosis of AMI were 100%、84%、89.2% and 100% respectively. It is concluded that Mb is a very sensitive and more special marker for the diagnosis of AMI and helpful to differentiation from UAP.

关 键 词：心肌梗塞 肌红蛋白 诊断学 

分 类 号：R542.220.4[医药卫生—心血管疾病]