急性心肌梗死后快速肌红蛋白分析以评估冠状动脉再灌注情况。
Rapid myoglobin analysis to assess coronary artery reperfusion after acute myocardial infarction.
作者信息
Lee H S, Cross S J, Jennings K
机构信息
Department of Cardiology, Aberdeen Royal Infirmary, Scotland.
出版信息
Clin Cardiol. 1997 Sep;20(9):759-62. doi: 10.1002/clc.4960200909.
BACKGROUND
Coronary artery reperfusion significantly improves outcome in patients with acute myocardial infarction. A noninvasive method for assessing reperfusion in the early stage of infarction should be helpful in patient management.
HYPOTHESIS
We sought to assess whether release pattern of myoglobin is helpful in identifying patients with and without reperfusion following thrombolytic therapy for myocardial infarction.
METHODS
Myoglobin was measured before thrombolysis, half hourly for 4 h, then every 2 h for 10 h. Myoglobin was analyzed using a ward-based "rapid" and automated analyzer that yielded quantitative results within 10 min of blood collection.
RESULTS
In the 15 patients with coronary reperfusion, the time from thrombolysis to peak myoglobin levels (mean +/- SD, 2.4 +/- 1.5 h) was significantly lower than in nonreperfused patients (5.1 +/- 2.9, p < 0.01). As an indicator for reperfusion, a doubling of myoglobin 1 h after streptokinase achieved a sensitivity of 80%, a specificity of 80%, and a predictive accuracy of 80%.
CONCLUSIONS
The difference in myoglobin release kinetics is useful in identifying patients without coronary reperfusion and should aid in their management.
背景
冠状动脉再灌注可显著改善急性心肌梗死患者的预后。一种用于评估梗死早期再灌注情况的非侵入性方法应有助于患者的管理。
假说
我们试图评估肌红蛋白的释放模式是否有助于识别心肌梗死溶栓治疗后有或无再灌注的患者。
方法
在溶栓前测量肌红蛋白，随后4小时内每半小时测量一次，然后10小时内每2小时测量一次。使用病房内的“快速”自动分析仪分析肌红蛋白，该分析仪在采血后10分钟内得出定量结果。
结果
在15例冠状动脉再灌注患者中，从溶栓到肌红蛋白水平达到峰值的时间（均值±标准差，2.4±1.5小时）显著低于未再灌注患者（5.1±2.9小时，p<0.01）。作为再灌注的指标，链激酶注射1小时后肌红蛋白水平翻倍，其敏感性为80%，特异性为80%，预测准确性为80%。
结论
肌红蛋白释放动力学的差异有助于识别无冠状动脉再灌注的患者，并应有助于其管理。
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