Wang J X, Shi Q W, Wu T W, Jackowski G, Mickle D A
Department of Clinical Biochemistry, Toronto General Hospital, Ontario, Canada.
Clin Chim Acta. 1989 May 31;181(3):325-35. doi: 10.1016/0009-8981(89)90238-6.
To determine the clinical utility of human ventricular myosin light chain 1 (HVLC1) in the diagnosis of myocardial necrosis, we established a radioimmunoassay for serum HVLC1 using polyclonal antibodies raised against the purified human protein. HVLC1 levels were measured in sera from 110 control patients and 38 patients immediately after cardiovascular surgery and in serial specimens from 10 patients with uncomplicated myocardial infarctions. The HVLC1 assay was found to be equal in sensitivity for the first 48 hours to the CK-MB for myocardial necrosis after cardiovascular surgery and for myocardial infarction. In virtually all myocardial infarct patients, HVLC1 levels in sera rose within hours of the onset of chest pain. From thereon, two sub-trends were discerned. For many, the HVLC1 levels remain elevated for 9-12 days beyond. In some, the HVLC1 levels returned to normal levels 1-2 days after the initial rise, but became elevated again for the next 5-9 days. In either instance, the diagnosis of myocardial infarction was permitted as late as 10-12 days after the onset of chest pain which is in stark contrast to all conventionally used biochemical markers.
为了确定人心室肌球蛋白轻链1（HVLC1）在心肌坏死诊断中的临床应用价值，我们使用针对纯化的人蛋白制备的多克隆抗体建立了血清HVLC1放射免疫测定法。测定了110例对照患者和38例心血管手术后即刻患者的血清HVLC1水平，并对10例无并发症心肌梗死患者的系列标本进行了检测。结果发现，HVLC1测定法在术后48小时内对心血管手术后心肌坏死和心肌梗死的敏感性与肌酸激酶同工酶（CK-MB）相当。几乎所有心肌梗死患者血清中的HVLC1水平在胸痛发作数小时内升高。此后，可观察到两种亚趋势。许多患者的HVLC1水平在胸痛发作后9至12天内持续升高。部分患者的HVLC1水平在初次升高后1至2天恢复正常，但在接下来的5至9天再次升高。在这两种情况下，心肌梗死的诊断最晚可在胸痛发作后10至12天作出，这与所有传统使用的生化标志物形成鲜明对比。
