Delva E, Maillé J G, Solymoss B C, Chabot M, Grondin C M, Bourassa M G
J Thorac Cardiovasc Surg. 1978 Mar;75(3):467-75.
Serial determinations of creatine phosphokinase isoenzymes (CPK) were made during the operative period and the first postoperative week in 60 patients undergoing coronary artery bypass surgery. Electrocardiograms (ECG) and serum levels of glutamic oxaloacetic transaminase (SGOT) and lactic dehydrogenase (LDH) were also evaluated. All patients had increased CPK MB activity which first became detectable during the operative period. The CPK MB curves usually showed a peak during the first postoperative hours and then a rapid decay. Some curves, however, showed a different profile with a prolonged liberation of CPK MB. This type of curve was more frequent in patients with electrical signs of necrosis or ischemic injury. In this group, the total amount of CPK MB released was greater than that in patients with unchanged ECG tracings (p less than 0.05). A mean curve of CPK MB activity was calculated for the patients without electric and/or enzymatic signs of myocardial injury. Serum CPK MB determination is a useful technique for identifying perioperative myocardial infarction (MI) and the time sequence of its occurrence. The appearance of this isoenzyme in every patient undergoing coronary surgery is an interesting finding, and it significance needs to be clarified.
对60例接受冠状动脉搭桥手术的患者在手术期间及术后第一周进行了肌酸磷酸激酶同工酶（CPK）的系列测定。还评估了心电图（ECG）以及血清谷氨酸草酰乙酸转氨酶（SGOT）和乳酸脱氢酶（LDH）水平。所有患者的CPK MB活性均升高，最早在手术期间即可检测到。CPK MB曲线通常在术后最初数小时达到峰值，然后迅速下降。然而，一些曲线呈现出不同的形态，CPK MB释放时间延长。这种曲线类型在有坏死或缺血性损伤电信号的患者中更为常见。在这组患者中，释放的CPK MB总量大于心电图无变化的患者（p<0.05）。为无心肌损伤电信号和/或酶学信号的患者计算了CPK MB活性的平均曲线。血清CPK MB测定是识别围手术期心肌梗死（MI）及其发生时间顺序的有用技术。在每例接受冠状动脉手术的患者中出现这种同工酶是一个有趣的发现，其意义有待阐明。
