Hori M, Inoue M, Fukui S, Furukawa T, Abe H
Br Heart J. 1976 Jan;38(1):97-103. doi: 10.1136/hrt.38.1.97.
The serum creatine kinase (CK), aspartate transaminase (AST), lactic dehydrogenase (LD) and alpha-hydroxybutyric dehydrogenase (HBD) were determined before and 3, 6, 18, and 36 hours after cardiac catheterization and angiocardiography in 56 consecutive patients with ischaemic heart disease. Five of these patients whose serum enzyme levels were higher than normal before the procedure were excluded from the study. Forty-one of the remaining 51 patients had left ventriculography and also selective coronary arteriography. In these 41 patients (groups 1 and 2--see below), the mean serum CK levels increased after the procedure to exceed the upper limit of normal at every study interval. The mean serum AST, LD, and HBD levels generally remained within the normal range at all study intervals, though serum AST increased abnormally in 9 of the 41 patients (22%) and serum LD and HBD each increased above the normal limit in 2 of 41 patients (4.9%). In 24 patients (group 1) whose coronary arteriograms showed insignificant coronary narrowing (less than 75%) in any of the three major coronary arteries, the increase in serum CK was significantly higher than in 17 patients (group 2) with greater than 75% narrowings in at least one of the three major coronary arteries. However, the degree of serum CK elevation observed during the postangiographic period was much lower than that in another group of 30 consecutive patients with acute myocardial infarction. In 10 patients (group 3) who had the same procedure as groups 1 and 2 except without the selective coronary arteriography, the serum enzyme levels showed no noticeable increase after the procedure. The difference in postangiographic serum CK elevation between patients with and without selective coronary arteriography and the difference between group 1 (without significant coronory narrowing) and group 2 (with significant narrowing) strongly suggest that the raised serum CK levels represent some form of myocardial damage caused by the coronary arteriography, which, however, is different at least in degree from that of acute myocardial infarction.
对56例连续性缺血性心脏病患者在进行心导管插入术和心血管造影术前以及术后3小时、6小时、18小时和36小时测定血清肌酸激酶（CK）、天冬氨酸转氨酶（AST）、乳酸脱氢酶（LD）和α-羟丁酸脱氢酶（HBD）。其中5例患者在手术前血清酶水平高于正常，被排除在研究之外。其余51例患者中的41例进行了左心室造影和选择性冠状动脉造影。在这41例患者（1组和2组，见下文）中，术后平均血清CK水平在每个研究时间段均升高并超过正常上限。平均血清AST、LD和HBD水平在所有研究时间段一般保持在正常范围内，不过41例患者中有9例（22%）血清AST异常升高，41例患者中有2例（4.9%）血清LD和HBD各自升高超过正常上限。在24例患者（1组）中，其冠状动脉造影显示三支主要冠状动脉中任何一支的冠状动脉狭窄均不明显（小于75%），血清CK的升高显著高于17例患者（2组），后者三支主要冠状动脉中至少有一支狭窄大于75%。然而，血管造影术后观察到的血清CK升高程度远低于另一组30例连续性急性心肌梗死患者。在10例患者（3组）中，他们进行了与1组和2组相同的手术，但未进行选择性冠状动脉造影，术后血清酶水平未见明显升高。有或无选择性冠状动脉造影患者血管造影术后血清CK升高的差异以及1组（无明显冠状动脉狭窄）和2组（有明显狭窄）之间的差异强烈表明，血清CK水平升高代表冠状动脉造影引起的某种形式的心肌损伤，然而，这种损伤至少在程度上与急性心肌梗死不同。
