DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY DETECTION OF CIRCULATING CARDIAC MYOSIN LIGHT-CHAINS
DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY DETECTION OF CIRCULATING CARDIAC MYOSIN LIGHT-CHAINS
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DOI：
10.1016/s0002-9149(84)80126-5
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发表时间：
1984-01-01
影响因子：
2.8
通讯作者：
KHAW, BA
中科院分区：
文献类型：
--
作者：
KATUS, HA;YASUDA, T;KHAW, BA
开发并评估了人心肌肌球蛋白轻链 (CM-LC) 的放射免疫测定法，作为急性心肌梗死 (AMI) 的选择性诊断测试。该测定的血清灵敏度为 1.0 ng/ml (.±.2 S.D.)。 83 名确诊的 AMI 患者在病程中的某个时间均表现出 CM-LC 血浆浓度升高。在获得早期血液样本的 9 名患者中，有 7 名患者在胸痛发作后 6 小时内达到了诊断浓度。此时只有 2 人的总肌酸激酶水平升高。 CM-LC 浓度在第 2 至 4 天达到峰值，但在严重 AMI 患者中持续升高超过 1 周。在梗塞前期综合征中，15 名患者中有 8 名至少出现过一次 CM-LC 水平升高。在 15 名稳定型心绞痛患者中，只有 1 名患有充血性心力衰竭的患者表现出 L 链水平升高。通过该方法在健康人 (n = 72)、最近肌肉注射的患者 (n = 3) 或患有各种全身性疾病的患者 (n = 14) 的血清中未检测到 CM-LC 水平。在使用心脏和骨骼肌肌球蛋白 L 链之间具有 25% 交叉反应性的抗血清进行的初步研究中，3 名患有广泛骨骼肌损伤的患者的浓度似乎有所升高。尚未对出现此发现的患者进行更特异性的抗血清检查（8% 交叉反应性）。循环中CM-LC升高的持续时间可能与心肌损伤的程度有关。因此，该方法可以提供早期和晚期心肌坏死的特异性和灵敏的诊断。
A radioimmunoassay for human cardiac myosin light chains (CM-LC) was developed and evaluated as a selective diagnostic test for acute myocardial infarction (AMI). The assay had a sensitivity of 1.0 ng/ml (.+-. 2 S.D.) in serum. Eighty-three patients with confirmed AMI all showed an elevated plasma concentration of CM-LC at some time during the course of their illness. Of 9 patients from whom early blood samples were obtained, 7 had diagnostic concentrations within 6 h from the onset of chest pain. Only 2 had an elevated total creatine kinase level at this time. CM-LC concentrations peaked on days 2 to 4, but remained elevated in patients with large AMI for more than 1 wk. In preinfarction syndrome, 8 of 15 patients had elevated CM-LC levels at least once. Of 15 patients with stable angina pectoris, only 1 patient, who had congestive heart failure, showed elevated L chain levels. CM-LC levels were not detectable by this method in the sera of healthy persons (n = 72), patients with recent intramuscular injection (n = 3), or those with a variety of systemic illnesses (n = 14). In initial studies using an antiserum having 25% cross-reactivity between cardiac and skeletal muscle myosin L chains, 3 patients who had extensive skeletal muscle damage appeared to have elevated concentrations. Patients with this finding have not yet been examined with a more specific antiserum (8% cross-reactivity). The duration of CM-LC elevation in the circulation may be related to the extent of myocardial damage. This method may therefore provide a specific and sensitive diagnosis of early as well as late myocardial necrosis.