Usui A, Kato K, Abe T, Murase M, Tanaka M, Takeuchi E
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
Clin Chem. 1989 Sep;35(9):1942-4.
Concentrations of S100a0 protein and CK-MB were measured by enzyme immunoassay in serial samples of arterial and coronary-sinus blood and urine taken from 26 patients who were undergoing mitral valve surgery. The mean concentration of arterial S100a0 in plasma was 0.32 (SD 0.28) ng/mL at the beginning of anesthesia, increased sharply after reperfusion, peaking [14.4 (SD 6.63) ng/mL] after 45 min of reperfusion, then decreased rapidly. The concentration of creatine kinase (CK) isoenzyme MB in arterial blood plasma was greatest 3 h after reperfusion [107 (SD 54.5) ng/mL]. S100a0 concentrations in urine increased dramatically after reperfusion [16,300 (SD 12,000) ng/h vs 44 (SD 32) ng/h], while CK-MB increased slightly [135 (SD 75) ng/h vs 19 (SD 12) ng/h]. These results suggest that S100a0 in cardiac muscle is released into the bloodstream during open-heart surgery and is discharged into the urine more rapidly than is CK-MB. Determination of S100a0 in plasma or urine thus may be useful for estimating damage to heart muscle during open-heart surgery.
采用酶免疫分析法对26例接受二尖瓣手术患者的动脉血、冠状窦血及尿液系列样本中的S100a0蛋白和肌酸激酶同工酶MB（CK-MB）浓度进行了测定。麻醉开始时血浆中动脉S100a0的平均浓度为0.32（标准差0.28）ng/mL，再灌注后急剧升高，在再灌注45分钟后达到峰值[14.4（标准差6.63）ng/mL]，随后迅速下降。动脉血浆中肌酸激酶（CK）同工酶MB的浓度在再灌注3小时后最高[107（标准差54.5）ng/mL]。再灌注后尿液中S100a0浓度急剧升高[16,300（标准差12,000）ng/h比44（标准差32）ng/h]，而CK-MB略有升高[135（标准差75）ng/h比19（标准差12）ng/h]。这些结果表明，心肌中的S100a0在心脏直视手术期间释放到血液中，并且比CK-MB更快地排入尿液。因此，测定血浆或尿液中的S100a0可能有助于评估心脏直视手术期间的心肌损伤。
