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【摘要】 目的 观察冠心病急性心肌梗死(AMI)患者溶栓治疗前后血浆心肌营养素-1(CT-1)和B-型尿钠肽(BNP)变化及意义。方法 ①溶栓组于溶栓即刻、溶栓后2、4、6、8、10、12 h测定血中CT-1和BNP浓度;②未溶栓组于症状出现后2、4、6、8、10、12、14 h测定血中CT-1和BNP浓度。同时测定血清心肌酶CK-MB的浓度。结果 ①AMI后2~7 d,患者NBP水平明显升高,平均为(544.5±321.2)ng/L,明显高于正常对照组(P 1.2 方法
1.2.1 标本采集 对照组:健康对照组。早晨8时抽取空腹静脉血等测。实验组:AMI患者。其中未溶栓组要求于症状出现后2、4、6、8、10、12、14 h采血;溶栓组要求于溶栓即刻、溶栓后2、4、6、8、10、12 h采血。第2~7天,抽取静脉血。 上述血样均静置并离心(1500转/min),汲取上清,置于-30℃冰箱冻存至测定。
1.2.2 BNP测定 荧光免疫法定量测BNP浓度,仪器的准确性、敏感性、稳定性在检测前进行质控。BNP检测范围从1 ng/L到5 000 ng/L。
1.2.3 CT-1 测定CT-1测定采用美国ADL公司Rat anti-human CT-1试剂盒,应用双抗体夹心酶标免疫分析法测定。
实验组血清同时检测CK-MB和肌钙蛋白T(TnT)浓度,由医院检验科测定,正常值0.05);溶栓未再通组CT-1水平低于溶栓再通组,而BNP浓度高于再通组(P 综上所述,本结果提示CT-1和BNP可反映AMI后心肌损害的存在及其程度, 可早期诊断AMI后心肌损伤,且可间
接反映溶栓后血管是否再通。早期检测CT-1和BNP可以指导临床早期干预,减少并发症。同时,CT-1和BNP也有可能为心肌损伤的治疗提供新的途径。
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