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急性心肌梗死及冠状动脉再灌注患者的血清肌酸激酶同工酶MB和肌红蛋白

[Serum creatine kinase isoenzyme MB and myoglobin in patients with acute myocardial infarction and coronary reperfusion].

作者信息

Jurlander B, Clemmensen P M, Ohman E M, Wagner G S, Grande P

机构信息

Medicinsk afdeling B, Rigshospitalet, København.

出版信息

Ugeskr Laeger. 1992 Sep 21;154(39):2682-6.

PMID:1413198
Abstract

Thrombolytic therapy in patients with acute myocardial infarction (AMI) changes the time-concentration curve of serum creatine kinase isoenzyme MB (CK-MB) and serum myoglobin. In this study, 60 AMI patients received thrombolytic therapy and acute coronary arteriography, or conservative treatment. Group one (n = 32) demonstrated a patent infarct-related artery after intravenous thrombolytic therapy; group two (n = 17) had an initially occluded coronary artery which became patent during catheterisation; group three (n = 11) did not receive thrombolytic therapy. Frequent serum CK-MB and myoglobin measurements showed that patients with acute coronary reperfusion had a rapid increase, an earlier peak value and less total release of both CK-MB and myoglobin to blood compared to AMI patients treated conservatively. The changes in serum myoglobin compared to CK-MB demonstrated an even more rapid, more uniform, and relatively greater increase. Measurements of serum myoglobin may be a useful non-invasive method for evaluation of thrombolytic therapy in AMI patients.

摘要

急性心肌梗死(AMI)患者的溶栓治疗会改变血清肌酸激酶同工酶MB(CK-MB)和血清肌红蛋白的时间-浓度曲线。在本研究中,60例AMI患者接受了溶栓治疗及急性冠状动脉造影,或保守治疗。第一组(n = 32)在静脉溶栓治疗后梗死相关动脉通畅;第二组(n = 17)最初冠状动脉闭塞,但在导管插入术期间变为通畅;第三组(n = 11)未接受溶栓治疗。频繁测定血清CK-MB和肌红蛋白表明,与接受保守治疗的AMI患者相比,急性冠状动脉再灌注患者的CK-MB和肌红蛋白向血液中的释放均迅速增加、峰值出现更早且总量更少。与CK-MB相比,血清肌红蛋白的变化显示出更快、更均匀且相对更大的增加。测定血清肌红蛋白可能是评估AMI患者溶栓治疗的一种有用的非侵入性方法。

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