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[单克隆抗体检测急性心肌梗死患者心肌肌球蛋白轻链I]

[Detection of cardiac myosin light chain I by monoclonal antibody in the patients with acute myocardial infarction].

作者信息

Ye P, Harris P J, dos Remedios C G

机构信息

Division of Geriatric Cardiology, General Hospital, PLA, Beijing, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 1991 Oct;19(5):308-10, 331-2.

PMID:1817016
Abstract

Plasma cardiac myosin light chain I(CMLCI) was quantified by competitive enzyme-linked immunosorbent assay(ELISA) using a monoclonal antibody in 42 patients with confirmed acute myocardial infarction (AMI). In comparison to the value from healthy individuals, plasma CMLCI levels were significantly elevated in 40 patients. In 28 of the 42 patients (66.7%), two major peaks were observed on time activity curves. The early peak (CMLCIp1) began a rapid rising within 4-12 hours and peaked at a mean of 25 hours following the onset of chest pain. The CMLCIp1 appeared statistically higher and earlier in patients with early infarct-related artery recanalization (IRAR) than those without IRAR, which was assessed by CPK peaking time, continuous ST segment monitoring on 12 lead ECG and symptoms. Thus, CMLCIp1 might be influenced by early IRAR. The late peak (CMLCIp2), which was composed of another gradual increase of plasma CMLCI level, occurred at a mean of 142 hours after AMI and remained elevated for about 7-10 days. The magnitudes of CMLCIp2 were correlated with the infarct size estimated by LVEF and LVWMS on cineventriculography and QRS scores on ECG. In the rest 14 patients only one peak was observed. It was suggested that CMLCIp1 could provide an early diagnosis of AMI and might be influenced by early IRAR after thrombolysis, while CMLCIp2 was a good later marker of extent of myocardial necrosis.

摘要

采用单克隆抗体,通过竞争性酶联免疫吸附测定(ELISA)法对42例确诊为急性心肌梗死(AMI)的患者血浆中心肌肌球蛋白轻链I(CMLCI)进行定量分析。与健康个体的值相比,40例患者的血浆CMLCI水平显著升高。在42例患者中的28例(66.7%),在时间-活性曲线上观察到两个主要峰值。早期峰值(CMLCIp1)在胸痛发作后4 - 12小时内开始快速上升,平均在25小时达到峰值。通过肌酸磷酸激酶(CPK)峰值时间、12导联心电图连续ST段监测及症状评估,发现早期梗死相关动脉再通(IRAR)的患者CMLCIp1在统计学上出现得更高且更早,因此,CMLCIp1可能受早期IRAR影响。晚期峰值(CMLCIp2)由血浆CMLCI水平的另一次逐渐升高组成,平均在AMI后142小时出现,并持续升高约7 - 10天。CMLCIp2的幅度与通过心室造影的左心室射血分数(LVEF)和左心室壁运动评分(LVWMS)以及心电图的QRS评分估计的梗死面积相关。其余14例患者仅观察到一个峰值。提示CMLCIp1可对AMI进行早期诊断,且可能在溶栓后受早期IRAR影响,而CMLCIp2是心肌坏死范围的良好晚期标志物。

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