Pang S C, Chiang C W, Fu M, Lin F C, Lee C P, Yeh S J, Kuo C T, Hsu T S, Lee Y S
Department of Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Jpn Heart J. 1988 Sep;29(5):631-8. doi: 10.1536/ihj.29.631.
Early elevation of the serum myoglobin level in acute myocardial infarction (AMI) has been noted for years. In this study, 39 patients admitted to the Coronary Care Unit with acute chest pain within 72 hours (mean 12 +/- 15 hours) or electrocardiographic changes suspected of acute myocardial infarction had a serum myoglobin latex agglutination test to evaluate its diagnostic accuracy in acute myocardial infarction. Of these 39 patients, 24 had documented acute myocardial infarction as their final diagnosis. By the time of admission, 18 of the 24 cases with infarction had positive myoglobin tests (sensitivity 75%). Of those 15 cases without myocardial infarction, 13 had negative myoglobin tests (specificity 87%). If only those 17 cases admitted within 5 hours of the onset of chest pain were analyzed, the serum myoglobin test became positive in 8 of 10 cases with documented AMI but the 2 cases with negative results turned positive 2 hours later (sensitivity 80% to 100%). Due to the fact that myoglobin tests were negative in all other 7 cases without infarction, the specificity was 7/7 (100%). In contrast, the creatine phosphokinase isoenzyme study was positive only in 3 of these 10 patients with documented AMI in the first blood sample taken during admission. In conclusion, the serum myoglobin latex agglutination test is a quick and reliable method that helps in the early diagnosis of acute myocardial infarction.
急性心肌梗死（AMI）患者血清肌红蛋白水平的早期升高多年来已为人所知。在本研究中，39例在72小时内（平均12±15小时）因急性胸痛入住冠心病监护病房或有疑似急性心肌梗死心电图改变的患者，接受了血清肌红蛋白乳胶凝集试验，以评估其在急性心肌梗死中的诊断准确性。在这39例患者中，24例最终诊断为确诊的急性心肌梗死。入院时，24例梗死患者中有18例肌红蛋白检测呈阳性（敏感性75%）。在15例无心肌梗死的患者中，13例肌红蛋白检测为阴性（特异性87%）。如果仅分析胸痛发作后5小时内入院的17例患者，10例确诊为AMI的患者中有8例血清肌红蛋白检测呈阳性，但2例结果为阴性的患者在2小时后转为阳性（敏感性80%至100%）。由于其他7例无梗死患者的肌红蛋白检测均为阴性，特异性为7/7（100%）。相比之下，在入院时采集的第一份血样中，这10例确诊为AMI的患者中只有3例肌酸磷酸激酶同工酶检测呈阳性。总之，血清肌红蛋白乳胶凝集试验是一种快速可靠的方法，有助于急性心肌梗死的早期诊断。
