Varat M A, Mercer D W
Circulation. 1975 May;51(5):855-9. doi: 10.1161/01.cir.51.5.855.
The specific and sensitivity of serum creatine phosphokinase cardiac specific isoenzyme (MB) in the diagnosis of acute myocardial infarction (AMI) was evaluated. An ion-exchange chromatographic technique was used to isolate MB. Sera layered on mini-columns of DEAE-Sephadex were eluted with Tris-buffered sodium chloride. Quantification of isolated MB was performed by creatine phosphokinase (CPK) assay (Rosalki method) of column effluents. MB was expressed as a percentage of the simultaneously determined total serum CPK; MB was determined in 100 consecutive admissions to the Coronary Care Unit. Acute myocardial infarction was diagnosed by accepted criteria. In 47 patients with proven AMI, including three with normal total CPK, peak MB was greater than 4% of total CPK. In 49 patients without AMI, including 15 with elevated total CPK (due to trauma, injections, cardioversion), peak MB was less than 2% of total CPK. MB was elevated, but did not peak in four patients without AMI but with chronic atrial fibrillation. Isolation and quantification of MB by this technique is rapidly and easily performed and provides a specific and extremely sensitive tool for the diagnosis of AMI.
评估了血清肌酸磷酸激酶心脏特异性同工酶（MB）在急性心肌梗死（AMI）诊断中的特异性和敏感性。采用离子交换色谱技术分离MB。将血清加样于DEAE-葡聚糖凝胶小柱上，用Tris缓冲氯化钠溶液洗脱。通过对柱流出液进行肌酸磷酸激酶（CPK）测定（罗萨尔基法）对分离出的MB进行定量。MB以同时测定的血清总CPK的百分比表示；对冠心病监护病房连续收治的100例患者测定了MB。根据公认标准诊断急性心肌梗死。在47例确诊为AMI的患者中，包括3例总CPK正常的患者，MB峰值大于总CPK的4%。在49例无AMI的患者中，包括15例总CPK升高（由于创伤、注射、心脏复律）的患者，MB峰值小于总CPK的2%。4例无AMI但患有慢性心房颤动的患者MB升高但未出现峰值。通过该技术分离和定量MB快速、简便，为AMI的诊断提供了一种特异性强且极其灵敏的工具。
