MYOSIN HEAVY-CHAIN FRAGMENTS AND CARDIAC TROPONINS IN THE SERUM IN RHABDOMYOLYSIS - DIAGNOSTIC SPECIFICITY OF NEW BIOCHEMICAL MAKERS
MYOSIN HEAVY-CHAIN FRAGMENTS AND CARDIAC TROPONINS IN THE SERUM IN RHABDOMYOLYSIS - DIAGNOSTIC SPECIFICITY OF NEW BIOCHEMICAL MAKERS
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DOI：
10.1001/archneur.1995.00540360090020
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发表时间：
1995-12-01
影响因子：
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通讯作者：
SOMER, H
中科院分区：
文献类型：
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作者：
LOFBERG, M;TAHTELA, R;SOMER, H
背景：肌球蛋白是肌肉的主要结构蛋白。β型重肌球蛋白抗体与心肌和慢收缩骨骼肌反应。心肌肌钙蛋白T和肌钙蛋白I被开发为组织特异性indicators.Objectives：研究肌球蛋白重链片段作为以前的横纹肌溶解症的延迟标记。研究心肌肌钙蛋白T（TnT）和心肌肌钙蛋白I（TnI）的心脏特异性在严重的骨骼肌damage.Design和方法：血清肌球蛋白重链片段，TnT和TnI的患者进行了研究，诊断后12天的关系，血清肌酸激酶水平在20例横纹肌溶解症。血清肌酸激酶活性峰值平均为91300 U/L。肌球蛋白重链片段测定的免疫放射分析，TnT的一步免疫酶法测定，和TnI的免疫酶法测定。结果：血清肌球蛋白重链片段的值均大于正常上限的所有患者。峰值（平均为正常上限的70倍）通常在诊断横纹肌溶解症后4 - 7天达到，并增加至12天。95%的患者TnT峰值升高，且与血清肌酸激酶峰值活性密切相关。30%的患者的最高TnI值超过心肌梗死的检测限。这些患者中有一半是唯一的患者进行入院时心电图上观察到的缺血性变化hospital.Conclusions：肌球蛋白重链片段的测量是有用的，在过去的横纹肌溶解症的诊断长达12天。TnT作为重度横纹肌溶解症患者心肌损伤的指标的作用可以忽略不计。心肌肌钙蛋白I是一种更具组织特异性的心肌损伤标志物，即使伴有横纹肌溶解症。
Background: Myosin is the major structural protein in muscle. Antibodies to beta-type heavy meromyosin react with cardiac and slow-twitch skeletal muscle. Cardiac TnT and TnI were developed as tissue-specific indicators.Objectives: To study myosin heavy-chain fragments as a delayed marker of previous rhabdomyolysis. To examine the cardiac specificity of cardiac troponin T (TnT) and cardiac troponin I (TnI) in patients with severe skeletal muscle damage.Design and Methods: Serum myosin heavy-chain fragments, TnT, and TnI were studied up to 12 days after diagnosis in relationship to the serum creatine kinase level in 20 patients with rhabdomyolysis. The mean peak serum creatine kinase activity was 91 300 U/L. Myosin heavy-chain fragments were measured by an immunoradiometric assay, TnT by a one-step immunoenzymometric assay, and TnI by an immunoenzymometric assay.Results: Values for serum myosin heavy-chain fragments were greater than the upper limit of normal in all patients. The peak value (70 times the upper normal limit, on average) was usually achieved 4 to 7 days after the diagnosis of rhabdomyolysis, and it was increased up to 12 days. The peak level of TnT was increased in 95% of the patients, and it correlated strongly with the peak activity of serum creatine kinase. The highest TnI value was above the detection limit of myocardial infarction in 30% of the patients. Half of these patients were the only patients with ischemic changes observed on an electrocardiogram performed on admission to the hospital.Conclusions: The measurement of myosin heavy-chain fragments was useful in the diagnosis of previous rhabdomyolysis up to 12 days. The role of TnT was negligible as an indicator of cardiac muscle damage in patients with severe rhabdomyolysis. Cardiac TnI is a more tissue-specific marker for myocardial damage even with concurrent rhabdomyolysis.-