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Mioglobinemija u trombolitičkom liječenju akutnog infarkta miokarda : magistarski rad
Kržišnik-Zorman, Simona
Myoglobin is an intracellular hem-protein. The aim of the study was to comparethe time course of serum myoglobin concentration (Mb) in patients with successful and unsuccessful thrombolytic treatment ...of acute myocardial infarction (AMI). Forty-seven patients with AMI treated with brief high-dose streptokinase or urokinase were included. Reperfusion was achieved in 29 patients, in 18 there was no reperfusion. In reperfused group the time to peakMb (tMb was 120 +- 50 minutes (median +- quartile deviation). Maximal rateof Mb rise (Va max) was 30.3 +- 13.2 microg/ml min. The time required for Mb to rise from 50% to 100% of peak value (t50-100) was 41 +- 15 minutes. The maximal rate of Mb decline (Vd max) was 11.4 +- 6.4 microg/ml min. The time required for Mb to decline from peak to 50% (t100-50) was 93 +- 26 minutes. Innonreperfused group tMb max was longer (360 +- 120 minutes), Va max was smaller (4.3 +- 2.5 microg/ml min), Vd max was smaller (1.9 +- 0.9 microg/ml min). T50-100 was 193 +- 104 minutes, t100-50 was 235 +- 102 minutes. The differences in all described parameters were statistically significant (p < 0.001). Three fold increase of Mb in first 120 minutes of thrombolytic treatment was 89% sensitive, 83% specific for reperfusion. Prognostic value was 89%. 25% decline of Mb in first hour after peak Mb was 89% sensitive and 100% specific for reperfusion, prognostic value was 89%. The time course of Mbdiffers in reperfused and nonreperfused group of patients with AMI. We consider it an early noninvasive sign of reperfusion which allows us to assessthe success of thrombolysis in first 2 hours of treatment.
Type of material - master's thesis
Publication and manufacture - Rijeka : [S.Kržišnik Zorman], 1994
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