老年与非老年人急性心肌梗死范围定量的心肌酶学研究

目的探讨老年与非老年人急性心肌梗死(AMI)酶学变化与梗死量的关系及意义。方法观察老年组与非老年组AMI血清肌酸激酶(CK)及同工酶(CK-MB)、丙酮酸激酶(PK)、谷草转氨酶(GOT)、乳酸脱氢酶(LDH)、a-羟丁酸脱氢酶(HBDH)活性-时间变化，计算其心肌梗死量。结果其中老年组56例AMI分别为(44.2±19.2)CK-g，(40.2±18.6)CK-MB-g，(38.2±18.5)PK-g，(46.1±21.4)COT-g，(49.5±23.4)LDH-g，(44.8±20.4)HBDH-g；非老年组69例AMI分别为(34.8±17.1)CK-g，(32.9±15.7)CKMB-g，(30.5±15.8)PK-g，(38.4±17.4)GOT-g，(40.9±20.7)LDH-g，(36.5±18.8)HBDH-g，老年组心肌梗死范围较大，两组差异显著(P<0.05)。结论定量判断AMI范围的大小，有助于早期判断其病情变化倾向、评价治疗措施及预后等。

MYOCARDIAL ENZYME STUDY IN QUANTITATION OF MYOCARDIAL INFARCT SIZE IN OLD AND YOUNG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective:To evaluate the myocardial infarct size and its value according to the dynamic changes of myocardial enzyme in old patients with acute myocardial infarction(AMI). Methods:The infarct sizes were determined by calculatoing activity-time changing curves of serum creatine kinase(CK), creatine kinase isozyme MB (CK-MB), pyruvate kinase (PK), glutamic oxalacetic transaminase (GOT), lactate dehydogenase (LDH) and hydroxybuty-rate debydrogenase(HBDH) in 125 patients with AMI. Results:The myocardial infarct sizes were (44.2 + 19.2)CK-g, (40.2 + 18.6)CK-MB-g, (38.2 + 18.5)PK-g, (46.1 + 21.4)GOT-g, (49.5 +23.4) LDH-g, (44.8 + 20.4) HBDH-g, respectively in 56 old patients, and in the other 69 patients the myocardial infarct sizes were (34.8 + 17.1 )CK-g, (32.9 + 15.7)CK-MB-g, (30.5 + 15.8)PK-g, (38.4 + 17.4)GOT-g,(40.9 + 20.7)LDH-g, (36.5 + 18.8)HBDH-g. The infarct sizes in older patients were increased significantly than those in younger patients(P < 0.05). Conclusion: The infarct size in old patients with AMI can help to judge the tendency of AMI and asses the treatment methods and predict prognosis.