肌红蛋白检测心肌梗死型冠心病的研究

目的:探讨肌红蛋白对心肌梗死型冠心病早期诊断的价值。方法:用ELISA法测定156例冠心病患者的肌红蛋白浓度,对其中66例心肌梗死型冠心病急性期入院患者,42例在冠脉再灌注前与再通治疗后进行比较;另观察40例不稳定型心绞痛患者,疼痛发作期和间歇期肌红蛋白含量及50例运动试验受试对象的结果。结果:心肌梗死型冠心病在起病后1.5 h肌红蛋白升高,42例在冠脉再通后(46.7±17.3)min出现升高峰值,平均为(889.9±47.3)μg/L,比再灌注前升高65.5%,肌红蛋白异常升高持续(37.3±6.8)h,另40例不稳定型心绞痛患者,疼痛发作期和间歇期肌红蛋白分别为(56.3±21.6)μg/L和(41.6±12.3)μg/L,自身对比差异无统计学意义(P>0.05);50例运动试验受试对象:运动前后分别为(33.7±12.4)μg/L和(46.3±21.3)μg/L。该两组与心肌梗死型冠心病组入院肌红蛋白相比,差异均有统计学意义(P<0.05)。心肌梗死型冠心病肌红蛋白诊断的敏感度为100%,特异度为84%,阳性预测值为89.2%,阴性预测值为100%。结论:肌红蛋白是心肌梗死型冠心病急性期诊断很敏感且较特异的生化指标,有助于与不稳定型心绞痛相鉴别。

Research progress of myoglobin detection in myocardial infarction

Objective To discuss the early diagnostic value of myoglobin in myocardial infarction. Method The myoglobin concentration of 156 cases with coronary heart disease was detected by ELISA method,among them,66 examples admitted in acute stage （42 examples with comparison of before reperfusion with after recanalization） ;40 examples with unstable angina pectoris and 50 examples of movement experiment objectives. Results Myoglobin ascended 1.5 h after onset ,42 examples reached peak value （46.7 ± 17. 3 ） rain after recanalizaion, the average was （ 889.9± 47. 3 ）μg/L, elevated 65.5% compared to before reperfusion ,the myoglobin continuously elevated for （37.3± 6. 8） h;another 40 examples with unstable angina peetofis, myoglobin concentrations in the ache attack and intermission period were （56. 3±21.6） μg/L and （41.6 ± 12. 3） μg/L,respeetively,own contrast showed no remarkable differenee（P 〉0. 05） ;50 examples of movement experiment objectives：Before and after movement were （33.7 ±12.4） μg/L and （46.3 ±21.3） μg/L,respectively. The admitted myoglobin concentrations of these two groups compared with the myocardial infarction patients, the difference was remarkable （ P 〈 0. 05 ）. The sensitivity of myoglobin in diagnosis of myocardial infarction was 100% ,the specificity was 84% ,the positive forecast value was 89.2% ,and the negative forecast value was 100%. Conclusion Myoglobin is the sensitive and specific biochemical indicator for the diagnosis of myocardial infarction in acute stage, and is helpful to the differential diagnosis with unstable angina pectoris.