Erlacher P, Lercher A, Falkensammer J, Nassonov E L, Samsonov M I, Shtutman V Z, Puschendorf B, Mair J
Department of Medical Chemistry and Biochemistry, Division of Clinical Biochemistry, University of Innsbruck, Innsbruck, Austria.
Clin Chim Acta. 2001 Apr;306(1-2):27-33. doi: 10.1016/s0009-8981(01)00392-8.
Cardiac troponin T (cTnT), cardiac troponin I (cTnI), myosin heavy chains (MHC), myoglobin, creatine kinase (CK), and creatine kinase isoenzyme MB (CKMB), were measured in blood samples from 39 polymyositis (PM) or dermatomyositis (DM) patients without clinical evidence for cardiac involvement to evaluate their clinical usefulness in this patient population. MHC, myoglobin, and CKMB were frequently elevated and correlated with each other and with disease severity. Undetectable cTnI in all but one patient indicated that MHC was released from skeletal muscle, thereby providing the first laboratory evidence of frequent slow-twitch muscle fibre-necrosis in patients with PM or DM. CKMB was elevated in 51%, cTnT in 41%, and cTnI in only 2.5% of patients. cTnI did not correlate with other markers or with disease severity scores. The close correlations found between cTnT and skeletal muscle damage markers and the relationship between cTnT with disease severity without clinical evidence for myocardial damage suggest a release of cTnT from skeletal muscle. The relationship of cTnT with disease severity indicates a possible role of the marker for risk stratification. However, the prognostic values of cardiac troponins and other muscle damage markers in PM/DM patients remain to be compared in prospective outcome trials.
在39例无心脏受累临床证据的多发性肌炎（PM）或皮肌炎（DM）患者的血样中检测了心肌肌钙蛋白T（cTnT）、心肌肌钙蛋白I（cTnI）、肌球蛋白重链（MHC）、肌红蛋白、肌酸激酶（CK）和肌酸激酶同工酶MB（CKMB），以评估它们在该患者群体中的临床实用性。MHC、肌红蛋白和CKMB经常升高，且彼此相关，并与疾病严重程度相关。除1例患者外，所有患者的cTnI均未检测到，这表明MHC是从骨骼肌释放的，从而为PM或DM患者频繁出现的慢肌纤维坏死提供了首个实验室证据。51% 的患者CKMB升高，41% 的患者cTnT升高，仅2.5% 的患者cTnI升高。cTnI与其他标志物或疾病严重程度评分均无相关性。在无心肌损伤临床证据的情况下，cTnT与骨骼肌损伤标志物之间的密切相关性以及cTnT与疾病严重程度之间的关系表明cTnT是从骨骼肌释放的。cTnT与疾病严重程度的关系表明该标志物在风险分层中可能发挥作用。然而，在前瞻性结局试验中，仍有待比较心脏肌钙蛋白和其他肌肉损伤标志物在PM/DM患者中的预后价值。
