Paucity of subtle myocardial injury after angioplasty delineated with MB CK.
Paucity of subtle myocardial injury after angioplasty delineated with MB CK.
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用 MB CK 描绘的血管成形术后很少出现轻微的心肌损伤。
DOI：
10.1002/ccd.1810120406
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Jaffe,AS
中科院分区：
文献类型：
--
作者：
Spadaro,JJ;Ludbrook,PA;Tiefenbrunn,AJ;Kurnik,PB;Jaffe,AS
为了确定 PTCA 引起轻微心肌缺血损伤的程度，对 28 名患者进行了前瞻性研究。通过分析频繁（每 4 小时）MB CK 连续样本（心肌损伤的敏感且特异的标志物）来评估心肌损伤的存在。在血管成形术之前，获取基线 12 导联心电图和血液样本，用于评估总 CK 和 MB CK。手术后立即和第二天早上采集额外的心电图，并在 24 小时内每隔 4 小时采集一次总 CK 和 MB CK 的系列样本。 PTCA 后 24 小时内需要进行心脏手术的患者被排除。样品 (n = 203) 采用玻璃珠法进行测定。只有 5 名患者的总 CK 升高超过 20 IU/L，其中 4 名患者接受了肌注术前用药。 12小时时平均MB CK为3.4±77±6.1IU/L，24小时时为4.1±4.7IU/L，而血管成形术前为3.1±1.7IU/L。只有一名患有明显梗塞的患者的 MB CK 值高于正常范围。因此，不复杂的 PTCA 并不伴有客观可检测的细微心肌损伤。
To determine the extent to which PTCA elicits subtle myocardial ischemic injury, 28 patients were studied prospectively. The presence of myocardial injury was assessed by analysis of frequent (q4 hours) serial samples of MB CK, a sensitive and specific marker of myocardial injury. Immediately prior to angioplasty, baseline 12‐lead ECGs and blood samples for evaluation of total CK and MB CK were obtained. Additional ECGs were obtained immediately after the procedure and on the following morning, and serial samples for total and MB CK were obtained at 4‐hour intervals for 24 hours. Patients requiring cardiac surgury within 24 hours after PTCA were excluded. Samples (n = 203) were assayed by the glass bead method. Total CK rose by more than 20 IU/L in only five patients, four of whom had received intramuscular premedication. Mean MB CK was 3.4 77± 6.1 IU/L at 12 hours and 4.1 ± 4.7 IU/L at 24 hours compared to 3.1 ± 1.7 IU/L prior to angioplasty. Only one patient with obvious infarction had a value for MB CK above the normal range. Thus, uncomplicated PTCA is not accompanied by objectively detectable subtle myocardial injury.