蛇毒去纤酶溶栓治疗急性心肌梗死患者乳酸脱氢酶同工酶谱的变化  

Changes in serum lactate dehydrogenase isoenzymes in acute myocardial infarction after defibrase thrombolysis

作　　者：孟庆义[1] 杜捷夫[1] 沈洪[1] 

机构地区：[1]解放军总医院急诊科,北京100853

出　　处：《中国危重病急救医学》2000年第3期151-153,共3页Chinese Critical Care Medicine

摘　　要：目的 :观察急性心肌梗死 (AMI)蛇毒去纤酶静脉溶栓治疗后血清乳酸脱氢酶 (L DH)同工酶谱的变化。方法 :采用琼脂凝胶电泳方法系列观察了 41例 AMI患者血清 L DH同工酶谱的改变 ,并与 2 0例正常人和2 7例不稳定型心绞痛患者进行比较。结果 :在 AMI患者中 ,蛇毒去纤酶治疗组 (1 9例 )血清 L DH、CK和 CKMB峰值较常规治疗组 (2 2例 )增高 ;并发现蛇毒去纤酶治疗组 L D4(0 .0 77± 0 .0 2 8)、L D5 (0 .1 2 7± 0 .0 86 )和L D5 / L D4(2 .1 8± 1 .2 9)峰值分别较常规治疗组 L D4(0 .0 39± 0 .0 1 9)、L D5 (0 .0 46± 0 .0 32 )和 L D5 / L D4(1 .32±0 .5 3)明显升高 (P均 <0 .0 1 )、但其它 L DH同工酶之间无显著性差异 (P均 >0 .0 5 )。结论 :蛇毒去纤酶治疗AMI患者有一定的加速心肌酶释放的作用 ,但蛇毒去纤酶还可能对肝脏有损害。Objective:To study the changes in the activities of serum lactate dehydrogenase and its isoenzymes in acute myocardial infarction after defibrase thrombolysis.Methods:Using agarose gel electrophoresis,the activities of serum lactate dehydrogenase and its isoenzymes in 41 patients with acute myocardial infarction were determined.Comparison were performed between 27 cases of unstable angina pectoris and 20 normal individuals.Results:In patients of acute myocardial infarction,the peak activities of CK,CKMB and LDH in defibrase group (19 cases) were higher than those in the group with conventional therapy group (22 cases),while the percentages of LD 4 (0 077±0 028),LD 5(0 127±0 086) and LD 5/LD 4 ratio(2 18±1 29) in defibrase group were also higher than those of the conventional therapy group (LD 4 0 039±0 019,LD 5 0 046±0 032,LD 5/LD 4 1 32±0 53,all P <0 01).No significant changes were found in other LD isoenzymes.Conclusions:There are significant release of serum lactate dehydrogenase and its isoenzymes after defibrase thrombolysis,which might be injurious to hepatic function.

关 键 词：急性 蛇毒去纤酶 乳酸脱氢酶 同工酶 心肌梗塞 

分 类 号：R542.22[医药卫生—心血管疾病]