摘要
目的探讨急性心肌梗死(AMD)患者心肌损伤标志物及尿激酶静脉溶栓治疗前后凝血五项监测指标的动态变化及临床应用价值。方法收治我院急性心肌梗死溶栓治疗成功患者10例,分别在溶栓前、溶栓后每2小时测一次心梗三项、心肌酶谱、凝血五项观察其变化。结果患者肌红蛋白、肌钙蛋白、肌酸激酶同工酶溶栓后在不同时间段升高并达到高峰;急性心肌梗死患者CK和CK-MB升高较早,幅度较大,LDH、HBD、AST血清中升高较慢;溶栓成功者APTT、PT、TT时间延长,FIB与溶栓后1 h迅速下降,D-D二聚体溶栓后0.5 h升高,1 h达高峰,1.5 h恢复到溶栓前水平。溶栓成功后逐渐恢复正常。结论急性心肌梗死实验室诊断指标呈动态规律性变化;溶栓治疗影响机体凝血系统、抗凝系统、纤溶系统,动态观察实验室监测指标,发现结果呈规律性变化。
Objective To investigate the markers of myocardial injury in patients with acute myocardial infarction （AMD） and the dynamic changes and clinical value of five monitoring indexes of blood coagulation before and after thrombolytic therapy with urokinase. Methods 10 patients with acute myocardial infarction treated with thrombolytic therapy in our hospital were treated. Three myocardial infarction, myocardial enzymes and five blood coagulation were measured before and after thrombolysis, every 2 h, respectively, and the changes were observed. Results Patients with myoglobin and troponin and creatine kinase isoenzyme after thrombolysis in different time increased and reached the peak; CK and CK-MB in patients with acute myocardial infarction increased earlier, larger, LDH, HBD, AST in serum increased slower; APTT, PT, successful thrombolysis prolonged TT, FIB and H decreased rapidly after thrombolysis in 1, D-D two dimer after thrombolysis 0.5 h increased, reached the peak at 1 h, 1.5 h recovered to the level before thrombolysis. After thrombolysis success gradually returned to normal. Conclusion Laboratory diagnosis of acute myocardial infarction index is dynamic changes; effects of thrombolysis with anticoagulation system, coagulation system and fibrinolytie system, dynamic observation and laboratory monitoring index, found the results showed regular changes.
出处
《中国继续医学教育》
2017年第10期63-64,共2页
China Continuing Medical Education
关键词
急性心肌梗死
实验诊断
溶栓治疗
止血和凝血
acute myocardial infarction
experimental diagnosis
thrombolytic therapy
hemostasis and coagulation
