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[利用肌红蛋白对冠状动脉再灌注进行无创评估:定量和半定量乳胶凝集法的意义]

[Non-invasive evaluation of coronary reperfusion using myoglobin: significance of quantitative and semi-quantitative latex agglutination methods].

作者信息

Abe S, Arima S, Yamaguchi H, Atsuchi Y, Tahara M, Nakao S, Tanaka H, Maruyama I, Nomoto K, Ueno M

机构信息

First Department of Internal Medicine, Faculty of Medicine, Kagoshima University.

出版信息

J Cardiol. 1991;21(4):847-55.

PMID:1844440
Abstract

We assessed the usefulness of myoglobin measured by latex agglutination methods as a parameter for successful reperfusion of the infarct-related artery. Plasma myoglobin levels were measured for 25 patients with acute myocardial infarction in whom thrombolysis and/or percutaneous transluminal coronary angioplasty (PTCA) were performed within 8 hours after the onset of symptoms. Blood samples were obtained before and 56 +/- 26 min (mean +/- SD) after commencing treatment. Plasma myoglobin levels were measured by quantitative and semi-quantitative latex agglutination methods, which required a procedure time of about 10 min. Coronary reperfusion was achieved by thrombolysis or PTCA in 22 cases (Group 1) but was not achieved by thrombolysis in 7 cases (Group 2). Before treatment (4.2 +/- 1.2 hours after the onset of symptoms), plasma myoglobin levels measured quantitatively and semi-quantitatively were 434 +/- 330 ng/ml and 4.6 +/- 4.2 fold, respectively. After treatment, the increased rate of myoglobin was significantly higher in Group 1 (8.4 +/- 7.5 and 9.2 +/- 7.1) than in Group 2 (1.8 +/- 0.5 and 1.7 +/- 0.5). Plasma myoglobin levels measured by quantitative and semi-quantitative latex agglutination methods showed a close correlation (r = 0.91, p < 0.01). In conclusion, measurement of plasma myoglobin levels by latex agglutination methods is a rapid and reliable way to confirm successful coronary reperfusion.

摘要

我们评估了通过乳胶凝集法测定的肌红蛋白作为梗死相关动脉成功再灌注参数的实用性。对25例急性心肌梗死患者进行了血浆肌红蛋白水平检测,这些患者在症状发作后8小时内接受了溶栓和/或经皮腔内冠状动脉成形术(PTCA)。在开始治疗前和治疗开始后56±26分钟(平均值±标准差)采集血样。采用定量和半定量乳胶凝集法测定血浆肌红蛋白水平,该方法所需操作时间约为10分钟。22例患者(第1组)通过溶栓或PTCA实现了冠状动脉再灌注,但7例患者(第2组)溶栓未成功。治疗前(症状发作后4.2±1.2小时),定量和半定量测定的血浆肌红蛋白水平分别为434±330 ng/ml和4.6±4.2倍。治疗后,第1组肌红蛋白的升高率(8.4±7.5和9.2±7.1)显著高于第2组(1.8±0.5和1.7±0.5)。通过定量和半定量乳胶凝集法测定的血浆肌红蛋白水平显示出密切相关性(r = 0.91,p < 0.01)。总之,通过乳胶凝集法测定血浆肌红蛋白水平是确认冠状动脉成功再灌注的一种快速且可靠的方法。

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