Castaldo A M, Ercolini P, Forino F, Basevi A, Vrenna L, Castaldo P, D'Ambrosio V, Castaldo A
Laboratorio di Patologia Clinica, Ospedale Cardinale Ascalesi, Napoli, Italy.
Eur J Clin Chem Clin Biochem. 1994 May;32(5):349-53. doi: 10.1515/cclm.1994.32.5.349.
Serum and plasma myoglobin and creatine kinase-MB catalytic activity were analysed in 157 patients admitted within 2 hours of the onset of chest pain (58 were retrospectively recognized as acute myocardial infarction). Serum and plasma values were highly correlated for both myoglobin and creatine kinase-MB. Plasma myoglobin appeared to be more sensitive than creatine kinase-MB for the early diagnosis of acute myocardial infarction; using a cut-off value of 100 micrograms/l, 90% of acute myocardial infarction cases were correctly recognized by plasma myoglobin 6 hours after the onset of chest pain, with a diagnostic specificity of 100% for non-acute myocardial infarction chest pain subjects. Plasma creatine kinase-MB showed a diagnostic sensitivity of 62% and a diagnostic specificity of 95% in the same group of patients. We suggest the inclusion of the plasma myoglobin immunonephelometric assay together with plasma creatine kinase-MB activity analysis in protocols for the early diagnosis of acute myocardial infarction.
对157例胸痛发作2小时内入院的患者（其中58例经回顾性诊断为急性心肌梗死）进行了血清和血浆肌红蛋白以及肌酸激酶-MB催化活性分析。血清和血浆中的肌红蛋白及肌酸激酶-MB值高度相关。血浆肌红蛋白对急性心肌梗死的早期诊断似乎比肌酸激酶-MB更敏感；以100微克/升为临界值，胸痛发作6小时后，血浆肌红蛋白能正确识别90%的急性心肌梗死病例，对非急性心肌梗死胸痛患者的诊断特异性为100%。在同一组患者中，血浆肌酸激酶-MB的诊断敏感性为62%，诊断特异性为95%。我们建议在急性心肌梗死早期诊断方案中纳入血浆肌红蛋白免疫比浊法检测以及血浆肌酸激酶-MB活性分析。
