Diagnostic changes in plasma creatine kinase isoforms early after the onset of acute myocardial infarction.
Diagnostic changes in plasma creatine kinase isoforms early after the onset of acute myocardial infarction.
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DOI：
10.1161/01.cir.74.1.105
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发表时间：
1986-07
期刊：
影响因子：
37.8
通讯作者：
Allan S. Jaffe;Harvey Serota;Ann M. Grace;B. Sobel
中科院分区：
文献类型：
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作者：
Allan S. Jaffe;Harvey Serota;Ann M. Grace;B. Sobel
在急性心肌梗死的最初几小时，常规血浆同工酶和酶值通常是正常的。因此，明确的诊断可能会延迟。我们最近发现，通过分析血浆中MM肌酸激酶（CK）亚型的相对活性，可以在冠状动脉闭塞后1小时内检测到犬的梗死。MM CK的亚型通过血浆中从组织释放的形式（MMA）的翻译后修饰演变为MMB和MMC。在这项研究中，我们量化了来自进展性心肌梗死患者、心绞痛患者和正常受试者的第一批可用血浆样本中亚型谱的变化。在26例对照受试者中，MMA与MMC的比值为1.09 +/- 0.4（SE）（范围为0.31 - 3.1;正常上限[定义为平均值加2 SD] 2.5）。在7名冠心病对照患者中，MMA与MMC的比值为1.3 +/- 0.3，范围为0.5至2.5。相比之下，在28例急性心肌梗死患者中，第一个可用血浆样本中MMA与MMC的比值平均为14.6 +/- 4.5（与两个对照组相比，p <0.01）。在疼痛发作后3.9 +/- 0.4小时获得第一个可用样品。28例患者中有24例（86%）MMA与MMC的比值大于2.5。（250字处删节）
Conventional plasma isoenzyme and enzyme values usually are normal during the first few hours of acute myocardial infarction. Thus definitive diagnosis may be delayed. We have shown recently that infarction in dogs can be detected within 1 hr after coronary occlusion by analysis of relative activities of MM creatine kinase (CK) isoforms in plasma. Isoforms of MM CK evolve through posttranslational modifications in plasma of the form released from tissue (MMA) to MMB and MMC. In this study we quantified changes in isoform profiles in the first available plasma samples from patients with evolving myocardial infarction, from patients with angina, and from normal subjects. In the 26 control subjects, the ratio of MMA to MMC was 1.09 +/- 0.4 (SE) (range 0.31 to 3.1; upper limit of normal [defined as the mean plus 2 SD] 2.5). In the seven control patients with coronary artery disease, the ratio of MMA to MMC was 1.3 +/- 0.3 with a range of 0.5 to 2.5. In contrast, among the 28 patients with acute myocardial infarction, the ratio of MMA to MMC in the first available plasma sample averaged 14.6 +/- 4.5 (p less than .01 compared with both control groups). First available samples were obtained 3.9 +/- 0.4 hr after the onset of pain. In 24 of 28 patients (86%) the ratio of MMA to MMC was greater than 2.5.(ABSTRACT TRUNCATED AT 250 WORDS)