【摘要】 目的:研究血清肌红蛋白(SMB)在急性心肌梗塞时的动态变化特征,做为早期诊断,再通判定指标及与肌酸磷酸激酶(CPK)对此其优越性:在判定再梗塞,梗塞延展和梗塞面积的实用价值。方法:①动物实验:兔36只,雌雄不限,随机分为对照组、结扎冠状动脉前降支;再通再梗塞组,动脉结扎6h 后放开,16h 后重新结扎;梗塞延展组,将结扎部位提高2mm;梗塞面积组,测梗塞不同时间坏死心肌重量。②临床实验:AMI 患者52例,男34例,女18例,平均年龄52.5±10.7岁,设正常人组69例,对照组21例。按设计方案在相应时间内采血检测心肌酶学、SMB、心电图改变,计算心肌坏死重量及相关性。结果:冠状动脉结扎2h 后 SMB 明显升高,4h 阳性率达100%,出现时间早,达峰值快,再通时迅速下降,再梗塞及梗塞延展时出现再次升高,形成第二峰值,SMB 浓度越高,心肌坏死越重,面积越大。结论:SMB 适用于早期诊断 AMI,估价梗塞面积大小,判定再通,再梗塞及梗塞延展,优于 CPK,是一种敏感而特异的生化指标。更多还原

【Abstract】 In an attempt to determine the practical value of serum myogobin(SMB)to diagnoses the a- cute myocardial infarction(AMI)earlier and to fudge the reinfarct size,the dynamic changes of SMB were studied,and also compared to the creatine phosphokinase(CPK).Animal experiment: thirty—six rabbits were divided into random four groups:control group,to release after six hours of ligation and to tie off after sixteen hours;infarction group,to high the infart part of 2mm;in- farct size group,to examine the myocardial weight in different time.Clinic experiment:forty—two cases of AMI(femal:18,male:34,average age:52.5±10.7)wete all studied.In addition,normal group was consisted of sixty—nine cases and control group was twenty—one cases.According to the design,blood samples were taken in different time to examinethe myocardial enzymoiogy, SMB.electrocardiogram(ECG).weight of AMI and the correlation among them.The result showed that SMBs were increased after two hours of ligation with positive rate of 100% after four hours.These indicated that in AMIthe SMB emerged earlier and quickly got peak value.On the other hand,the SMB decreased fast when released and increased again when reinfarcted,which formed the second pead value.The higher value of SMB,the stronger injure of myocardial infarc- tion.Our findings suggest that the SMB is useful and reliable in diagnosing the AMI earlier and valuing the infarct size,reinfarction and infarction.It is sensitive and special biochemical criterion.更多还原