血清肌红蛋白和CK-MB的联合检测在早期急性心肌梗塞中的应用

目的通过观察急性心肌梗塞（AMI）时血清肌红蛋白（MYO）和心肌肌酸激酶同工酶（CK-MB）的早期时相反应，评价MYO和CK-MB在早期AMI中的应用价值。方法选择127例急性胸痛高度怀疑AMI的患者，在持续性胸痛发作后2、4、6、8h各采血一次，分别应用胶乳增强免疫比浊技术和酶动力学法测定血清MYO和CK-MB的含量，并计算出相关参数。结果53例诊断为AMI，74例为非AMI。血清MYO在AMI发作后快速释放入血，2h开始上升，4-6h达高峰，峰值较参考上限升高5-20倍，CK-MB与之相比，反应明显较慢；发病4h内，MYO的敏感性、特异性分别为93.5％、67.0％，CK-MB对应值则为51.0％、79.7％。结论MYO在心肌细胞受损后具有快速释放的动力学特征，在AMI的早期，血清MYO的诊断敏感性较高，在溶栓治疗过程中，能迅速反应心肌再灌注情况，另外CK-MB的特异性较高；因此联合检测两项指标对AMI的早期诊断和排除，监测溶栓治疗效果，具有重要的应用价值。

Application of Joint Detection of Serum Mb and CK- Mb in the Early Diagnosis of Acute Myocardial Infarction

Objective To investigate the clinical implications of myoglobin（MYO） and creatine （CK - MB） in early phase response in patients with acute myocardial infarction（AMI）. Methods kinase isonazyme The venous blood samples from 127 AMI patients with actue stethalgia were collected at different time - points （2, 4,6, 8 h）after heart attack. Two indexes （MYO, and CK - MB） detection was completed within one hour with latex accentuation immune turbidime and enzyme kinetics by means of a full automatic chemiluminescence analyzer with relevant reagents. Correlate panneters were calculated. Results 53 patients were diagnosed as AMI, while 74 patients were not AMI. MYO can quickly release into blood after attack. It began to rise up at 2 h, reached the peak value within 4-6 h which was 5-20 times of the reference upper limit. But CK - MB reflects obviously slow. Within 4 h, the sensitivity and the specificity of MYO was 93.5% ,67%, and compared with CK - MB was 51% ,79.7%. Conclusions MYO can quickly release, and its sensitivity were higher. It can reflect myocardium resperfusion quickly in thrombolysis therapeuticst rategy. CK - MB have high specificity. Both of them are reliable biochemical markers for early diagnosis of AMI, so examition of their serum levels in combination have clinical significance in diagnosis, elimination, and prognostic judgement in thrombolysis.