Noble J, Garcia-Pascual B, Fathi M, Rosenbusch C A
Schweiz Med Wochenschr. 1976 Dec 18;106(51):1867-70.
A rapid method of determining creatine phosphokinase (CPK) isoenzymes using dithiothreitol, a reducing agent which activates the main fractions of the CPK molecule (MM and MB), was assessed in 68 subjects (34 with myocardial infarction, 18 with skeletal muscle lesions, 16 normal). In acute myocardial infarction, the mean peak of CPK-MB in serum increases to 13.3% of the total CPK (range 8.8% to 21%) from the 18th to the 24th hour after onset of symptoms, whereas in skeletal muscle lesions CPK-MB reaches only 1% of total CPK (range 0% to 2.9%), and in normal subjects CPK-MB is absent. This highly significant difference (p less than 0.001) makes it possible to distinguish accurately between myocardial infarction and skeletal muscle lesions (trauma, hematoma, myositis, hypothyroidism). By its sensitivity (100%) and specificity (97%) this rapid and inexpensive method finds its optimal sphere of application in emergency wards and coronary care units.
采用二硫苏糖醇（一种能激活肌酸磷酸激酶（CPK）分子主要组分（MM和MB）的还原剂）快速测定CPK同工酶的方法，在68名受试者（34例心肌梗死患者、18例骨骼肌损伤患者、16例正常人）中进行了评估。在急性心肌梗死中，血清中CPK-MB的平均峰值在症状发作后第18至24小时从总CPK的8.8%升至21%，平均达13.3%；而在骨骼肌损伤中，CPK-MB仅占总CPK的1%（范围0%至2.9%），在正常受试者中则不存在CPK-MB。这种高度显著的差异（p小于0.001）使得能够准确区分心肌梗死和骨骼肌损伤（创伤、血肿、肌炎、甲状腺功能减退）。凭借其敏感性（100%）和特异性（97%），这种快速且廉价的方法在急诊病房和冠心病监护病房找到了最佳应用领域。
