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[急性心肌梗死患者接受链激酶治疗后血浆中肌酸激酶同工酶早期峰值的预后价值]

[Prognostic value of an early peak CK-MB in plasma of patients treated with streptokinase for acute myocardial infarction].

作者信息

Stanisławska J, Opolski G, Słomka K, Niemczyk M, Górecki A, Tadeusiak W, Kraska T

机构信息

Kliniki Kardiologii Instytutu Chorób Wewnetrznych AM, Warszawie.

出版信息

Pol Arch Med Wewn. 1992 Nov;88(5):336-40.

PMID:1300554
Abstract

111 patients below 70 years old, with the first acute myocardial infarctions, 6 hours since the pain occurred--have been treated with streptokinase i.v. In 102 patients we obtained full curve of CK-MB activity. Early peak of CK-MB activity < 15 hours after onset of symptoms we have observed in 59 patients, and late peak of CK-MB activity > 15 hours in 43 patients. There was not any significant statistics differences between early and late groups in frequency of: early ventricular fibrillation (< 48 hours), complex ventricular arrhythmia (in 21 day), heart failure and in-hospital mortality. 1 patient died in hospital in early group and in late group also died 1 patient. The follow-up period was from 10 to 48 months (av. 26 +/- 13). 100 patients left the hospital and the full informations we have obtained in 97 cases. No one died in that time. In the group with early peak CK-MB activity we observed more often the unstable angina and the new myocardial infarction (21%) than in the group with late peak of CK-MB activity (15%), but these differences were nonsignificant. In conclusion our results don't confirm that the early peak of CK-MB activity is the positive risk factor of unstable angina and the new myocardial infarction.

摘要

111例70岁以下首次发生急性心肌梗死、疼痛发作后6小时的患者接受了静脉注射链激酶治疗。102例患者获得了肌酸激酶同工酶(CK-MB)活性的完整曲线。我们观察到,59例患者的CK-MB活性在症状出现后15小时内出现早期峰值,43例患者的CK-MB活性在15小时后出现晚期峰值。早期和晚期组在以下方面的发生率无显著统计学差异:早期室颤(<48小时)、复杂性室性心律失常(21天内)、心力衰竭和住院死亡率。早期组有1例患者在住院期间死亡,晚期组也有1例患者死亡。随访期为10至48个月(平均26±13个月)。100例患者出院,我们获得了97例患者的完整信息。在此期间无人死亡。与CK-MB活性晚期峰值组(15%)相比,CK-MB活性早期峰值组中不稳定型心绞痛和新发心肌梗死的发生率更高(21%),但这些差异无统计学意义。总之,我们的结果并未证实CK-MB活性早期峰值是不稳定型心绞痛和新发心肌梗死的阳性危险因素。

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