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心肌梗塞范围计算的研究Ⅱ:利用早期血清磷酸肌酸激酶活力改变预测梗塞范围

Investigation of Measuring the Extent of Myocardial Infarction Ⅱ. Predicting the Extent of Myocardial Infarction by Early Changes in Serum Creatinphosphokinase Activity

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【摘要】 1.本文报导4只麻醉开胸狗冠脉闭塞后用血清酶学计算、预测和病理组织法测量心肌梗塞范围的结果。预测法用早期血清磷酸肌酸激酶活力升高数据作最佳配合对数函数计算法。 2.对麻醉开胸冠脉闭塞狗血清磷酸肌酸激酶活力改变作了观察:在6小时内血清CPK几呈线性上升达峰值80%左右;而对照组在6—8小时才明显上升。两组峰值时间都约在12小时,但峰值,升高斜率Kr尤其是两者的乘积有明显差别。与清醒闭胸式对比,主要不同也在峰值以后。所以,此实验模型在峰值前尤其在前6小时,非心源性 CPK干扰很少,可供实验研究用。 3.从两组动物血清CPK升高率和峰值时间乘积对积分函数关系中,发现可从Kr直接求取积分函数。公式为:Kr(4.823)=integral from n=0 to T(f(t)dt),并设计从冠脉闭塞6小时预测血清CPK积分函数公式:■(c)=integral from n=0 to T(f(t)dt),其中C为可求得的常数,(?)的求法是:(?)=Et_b(0.125)/Pt:其中Et_b为冠脉闭塞后6小时血清CPK活力升高值,(?)为平均峰值时间,这样便可用于预测梗塞范围。由这些资料出发,讨论了一项真正撇开Kd,利用Kr计算和预测梗塞范围的设想。

【Abstract】 1. The characteristic changes of serum E(t) following experimental coronary occlusion under anesthesia for chest operation on four dogs were observed. There was a rapid increase in serum CPK activity immediately after coronary occlusion. And generally it attained 80% of the value of peak altitude in all 4 dogs with in 6 hours, while, the serum CPK activity of the control group showed a slight decrease, at first, and then returned to the basal level. At about the sixth hour it began to rise rapidly. The E(t) curves of both the infarcted group and the control group of animals reached the peak at about the same time (about 12 hours). However the peak altitudes and the kr of serum E(t), particularly their multiples were significantly different between infarcted and control dogs. The E(t) curves prior to the peak, especialls that during the first 6 hours after coronary occlusion, when non-cardial CPK release was negligible, were valuable for experimental study.2. In the obsevation of the multiple of Kr and the peak time value of serum E(t) correlating to those of integrated function of serum CPK activity, it was demonstrated that the accumulated function, i.e. the infarct size, can be directly estimated from Kr. The formuta is: Kr(4.823)=integral from n=0 to T f(t)dt. Furthermore, We have devised a simple formula for the prediction of infarct size during the first 6 hours after coronary occlusin under our experimental conditions: Kr(C)=integral from n=0 to T f(t)dt, wherein Kr=Et6(0.125)/Pt, C being a constant and Et6 stands for serum concentration at the 6-th hour, ■ expresses the average peak time of E(t) curves of experimental animals. Finally, a possibility of calculating and predicting the infarct size from Kr of serum E(t) regardless of the Kd value was discussed.3. Results of infarct size calculated and predicted from serum CPK activity based on empirical mathematical formulas in experimental infarcted animals were reported together with the data of infar ct size examined by patho-histological method.

  • 【文献出处】 天津医药 ,Tianjin Medical Journal , 编辑部邮箱 ,1981年06期
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