对1992年6月至1993年4月入院诊断为急性心肌梗塞(AMI)患者在发病后即时至48 h分三个阶段进行连续取血样测定4种血清酶(AST、CK、LDH、CKMB)的含量,且与心电图作比较.结果表明,在AMI过程中酶异常检出率最高可达到90%(AST、CK-MB),最低为70%(LDH).若以异常Q波为AMI确诊,其不能检出率为40%;提示在AMI早期作血清酶检测有助于进一步确诊及减少漏诊率.若AMI患者已下降的CK-MB再度上升,提示可能有新的梗死灶发生;AMI患者在发病6 h内,血清酶显著升高,提示预后不佳.
The serum cardiac enzymes in 30 cases of patients with acute myocardiac infarction(AMI) were studied. From the onset to 48 hours of AMI, the sera were collected in three different stages. By comparing with electrocardiogram respectively, the activities of AST,CK, LDH and CK-MB were measured. The results revealed that the highest positive rate of serum cardiac enzymes were 90%(AST,CK-MB), and the lowest positive rate was 70%(LDH).By using Q wave as a confirmatory index of AMI, the negative rate of cardiac enzymes was 40%. The early detection of increasing cardiac enzymes could indicate the presence of AMI. An increasing of CK-MB in patients with AMI indicated a possible new infarction occurred. A patient had increasing of cardiac enzymes within 6 hours of AMI might have a poor prognosis.
高玲,梁耀祖,温春光.常见血清酶测定在急性心肌梗塞诊断中的应用[J].生物化学与生物物理进展,1999,26(6):613-615
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