[Changes in plasma myoglobin levels in ischemic heart disease].

Giornale di clinica medica Pub Date : 1989-12-01
L Bastagli, G Guardigli, M Ruffini, N Spagnolo, F Fontana, G Puddu, C Ventura, D Patrono, M Capelli, P Bernardi
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Abstract

The aim of the present study is to evaluate the real need and the sensitivity of serum myoglobin levels as an early index for the diagnosis of acute myocardial infarction. A total of 62 patients (38 suffering from acute myocardial infarction, 16 from "angina pectoris", 8 from heart failure) and 20 healthy volunteers were included in the study. The patients with acute myocardial infarction were divided in 3 subgroups according to the time passed between the beginning of the pain and their admittance to our Department (Coronary Care Unit), that was, less than 6 hours, between 6 and 12 hours, between 12 and 24 hours. Among the patients with "angina", 8 presented spontaneous crisis whereas 4 had crisis only during treadmill test. 8 of the healthy volunteers received intramuscular injections of physiological solution every 12 hours during the 3 days preceding the study. In all subjects serum myoglobin level were measured by radioimmunoassay; in patients with acute myocardial infarction serum CK and MBCK levels with enzymatic method were measured too. No variation of plasma myoglobin levels was seen in patients with angina, neither in healthy volunteers had they received or not intramuscular injections. The low increase in plasma myoglobin levels observed in patients with heart failure might be due to a deficit of renal function. Serum myoglobin levels were significantly elevated in all the patients with acute myocardial infarction, whereas plasma CK and MBCK levels were significantly high only 6 hours after the necrosis. In myocardial infarction the levels of myoglobin rise during the first hours, peak at 10 hours and return to normal in 20 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

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[缺血性心脏病患者血浆肌红蛋白水平的变化]
本研究的目的是评估血清肌红蛋白水平作为急性心肌梗死诊断的早期指标的实际需要和敏感性。研究共纳入62例患者(急性心肌梗死38例,心绞痛16例,心力衰竭8例)和20名健康志愿者。将急性心肌梗死患者根据疼痛发生至入院时间分为6小时以内、6 ~ 12小时、12 ~ 24小时3个亚组。心绞痛患者自发性危像8例,仅在跑步机试验中出现危像4例。8名健康志愿者在研究前3天每12小时肌肉注射一次生理溶液。所有受试者均采用放射免疫法测定血清肌红蛋白水平;同时用酶法测定急性心肌梗死患者血清CK和MBCK水平。心绞痛患者血浆肌红蛋白水平未见变化,接受或未接受肌肉注射的健康志愿者也未见变化。心力衰竭患者血浆肌红蛋白水平的低升高可能是由于肾功能缺陷所致。所有急性心肌梗死患者血清肌红蛋白水平均显著升高,而血浆CK和MBCK水平仅在坏死后6小时显著升高。在心肌梗塞中,肌红蛋白的水平在最初的几个小时内升高,在10小时达到峰值,在20小时内恢复正常。(摘要删节250字)
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