急性心肌梗塞溶栓治疗血清肌钙蛋白T检测的临床价值  

Clinical value of serum troponin T after acute myocardial infarction

作　　者：马宇晨[1] 祁芸云[1] 张树彬[1] 丁文惠[1] 汪丽蕙[1] 李淑葵[1] 焦莉莉[1] 王淑娟[1] 

机构地区：[1]北京医科大学第一医院内科

出　　处：《中华心血管病杂志》1997年第5期387-389,共3页Chinese Journal of Cardiology

摘　　要：为了解肌钙蛋白Ｔ（ＴｎＴ）在不同情况下的释放入血情况以及与心功能受损的关系。本研究用链霉亲和素包被的一步夹心法动态测定了６４例急性心肌梗塞（ＡＭⅠ）患者血清ＴｎＴ的浓度，并用超声心动图的方法检查其心功能。结果显示：（１）溶栓组ＴｎＴ释放曲线呈双峰改变；（２）Ⅰ组（溶栓成功组２４例）与Ⅱ组（溶栓失败组１２例）比较，溶栓后２小时内ＴｎＴ上升速度差异有显著性（２．７９±０．９２μｇＬ－１／ｈ对０．５６±０．１２μｇＬ－１／ｈ，Ｐ＜０．０５）；第一峰与第二峰比值差异也有显著性（Ⅰ组１．８７±０．８１对Ⅱ组０．７７±０．２６，Ｐ＜０．０５）；（３）ＴｎＴ平均浓度和持续天数的乘积与１个月左室射血分数呈负相关（ｒ＝－０．８４，Ｐ＜０．０１）。提示：血管再通影响ＴｎＴ的释放动力曲线；血清ＴｎＴ２小时内的上升速度以及第一峰与第二峰的比值可作为溶栓成功的临床参考指标之一；ＴｎＴ释放入血的平均浓度与持续天数的乘积基本能反映心功能受损的情况。This study was designed to investigate the influences of thrombolysis on the kinetics of troponin T (TnT) release in acute myocardial infarction (AMI) and to find the relation of cumulative quantity of TnT release and dysfunction of heart by measuring serially serum TnT with ELISA one step “Sandwich” assay. The result showed: (1) The curve of TnT serum concentration in thrombolytic therapy groups was biphasic; (2) Within 2 hours after thrombolytic tharapy, the increase of TnT concentration in group I ( n =24, who had had successful reperfusion) was significantly faster than that in group Ⅱ ( n =12, who had not had successful reperfusion), (2.79±0.92 ng·ml -1 /h vs 0.56±0.12ng·ml -1 /h, P < 0.05); the ratio of TnT concentration at the first peak to that at the second peak in group I was also significantly higher than that in group Ⅱ (1.87±0.81 vs 0.77±0.26, P <0.01); (3)The product of cumulative quantity of TnT release correlated negatively with EF in 1 month after AMI ( r =-0.84, P < 0.01). The results suggested that the kinetics of TnT release in AMI was effected by reperfusion. The change of TnT concentration may be a good index determining successful reperfusion; the cumulative quantity of TnT can reflect cardiac dysfunction after AMI.

关 键 词：心肌梗塞 AMI 溶栓疗法 血清 肌钙蛋白T 测定 

分 类 号：R542.220.5[医药卫生—心血管疾病]