The material of this study comprised 30 patients with acute myocardial
infarction as a test group and 10 normal cases with matched
age and sex as a control group. The patients were divided into two
groups : Group (I); 15 patients (10) males and (b) females with ages
ranging between 41-72 years with a mean of 52.8 -I- 10.04 years, and
Group (ID; 15 patients (9) males and (6) females with ages ranging
between 50-62 years with a mean of 55.7 4- 3.68 years. Both groups
(I) and (II) received the usual treatment of myocardial infarction, in
addition group (II) patients received IV streptokinase as a thrombolytic
therapy. All patients were subjected to thorough history and full clinical
examination, the serum myoglobin levels were determined using the immunoturbidimetric
method, serum CPK and SGOT, fasting and postprandial
blood sugar and serum creatinine. A twelve leads ECG was done
for every patient on admission, just after therapy and 6 hours after
therapy (for streptokinase group). There was significant decrease in the
previously elevated ST segment in most cases who had received intravenous
streptokinase and in four treated cases the ST segment returned
back to the base line. In this study there was a significant increase of
serum myoglobin level in all patients of both groups (I) and (II) 6 hours
after the onset of chest pain; meanwhile the peak serum myoglobin level
recorded 6 hours after the onset of symptoms was higher in the first
group as compared to the second group (884.46 ± 176.9 1( g/litre versus
486.93 ± 95.43 μ g/litre). On the other hand, patients receiving intravonous
streptokinase therapy showed significantly low serum myoglobin
levels than non streptokinase treated patients after 12 hours from the
onset of symptoms. Also, myoglobin release stopped early in streptokinase
treated patients than in non streptokinase treated patients, as
control values were reached after 12 hours in contrast to 48 hours. respectively.
There was strong correlation between serum myoglobin level
and each of serum creatine phosphokinase (CPK) and serum oxalacetic
transaminase (SGOT) level of both non streptokinase and streptokinase
treated groups. This study illustrates the values of immunoturbidimetric
assay of serum mvoglobin as a sensitive marker for early diagnosis of
acute myocardial infarction and follow up of thrombolytic therapy for
these patients. |
