摘要
目的探讨心肌损伤指标动态检测在急性心肌梗死(AMI)再灌注治疗中的应用价值。方法选择87例我院心内科收治的12 h内ST段抬高型AMI患者,根据患者均予以再灌注治疗,对于患者再灌注前、治疗后2 h、6 h、12 h、24 h、36 h、48 h、3 d、7 d等进行心肌损伤标志物动态检测,包括蛋白肽类标志物人肌红蛋白(MYO)、肌钙蛋白(c Tnl)、超敏-C反应蛋白(hs-CRP),同时检测酶学类标志物,包括磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)及谷草转氨酶(AST)水平。结果AMI患者再灌注前各指标含量明显升高,显著高于治疗后7 d,差异具有显著性(P<0.05);蛋白肽类标志物MYO、c Tnl、hs-CRP再灌注治疗24 h内升高幅度均显著高于酶学类标志物CK-MB、LDH、AST,差异具有显著性(P<0.05),不同的心肌损伤指标在不同治疗之间达到峰值不一,其中MYO、c Tnl在治疗12~24 h即可到达峰值,hs-CRP、CK-MB在治疗24~36 h到达峰值,LDH峰值在治疗48 h^3 d,AST为治疗后36~48 h。结论蛋白肽类标志物和酶学类标志物均可作为急性AMI患者再灌注治疗的病情监测指标,其中蛋白肽类标志物更快速,有效反应病情变化,临床可采用多种心肌监测指标观察疾病进展。
Objective To investigate the application value of dynamic monitoring of myocardial injury indexes in reperfusion therapy of acute myocardial infarction（AMI）.Methods 87 cases of patients with ST-segment elevation AMI treated in the Department of Cardiology in our hospital were enrolled in the study.All patients were given reperfusion therapy.The myocardial injury markers were monitored dynamically,including protein peptide markers MYO（human myoglobin）,c Tnl（troponin）and hs-CRP（highsensitivity C reactive protein）.The levels of enzymological markers such as CK-MB（creatine kinase isoenzyme）,LDH（lactate dehydrogenase）and AST（aspartate aminotransferase）were detected.Results Levels of all indexes in AMI patients before reperfusion therapy were significantly higher than those at 7 days after treatment（P〈0.05）.The increased ranges of protein peptide markers（MYO,c Tnl,hs-CRP）within 24 h of reperfusion therapy were significantly greater than those of enzymological markers（CK-MB,LDH,AST）（P〈0.05）.The time of different myocardial injury indexes to peak were different.MYO and c Tnl can reached the peak in 12-24 h of treatment,hs-CRP and CK-MB reached the peak in 24-36 h of treatment,LDH reached the peak in 48 h-3 d of treatment,and AST reached the peak in 36 h -48 h after treatment.Conclusion Protein peptide markers and enzymological markers can be used as the indexes for monitoring the condition of patients with AMI treated by reperfusion therapy.The protein peptide markers can more rapidly and effectively reflect the changes of condition.In clinical practice,a variety of cardiac monitoring indexes can be used to observe the progression of disease.
出处
《哈尔滨医药》
2017年第5期424-425,共2页
Harbin Medical Journal
关键词
心肌损伤指标
AMI再灌注损伤
动态监测
Myocardial injury index
AMI reperfusion injury
Dynamic monitoring
