Thygesen K, Hørder M, Krøll L, Petersen P H, Haghfelt T
Eur J Clin Invest. 1986 Feb;16(1):1-4. doi: 10.1111/j.1365-2362.1986.tb01298.x.
Repetitive ischaemic episodes may have a cumulative effect leading to irreversible myocardial cell damage with enzyme release. Using plasma creatine kinase (CK) and creatine kinase B-subunit (CK-B) concentrations this theory has been tested in forty-eight patients admitted with acute chest pain, but without ECG signs of acute myocardial infarction (AMI). The patients were classified into four groups: Fourteen patients with non-ischaemic heart disease (non-IHD), seventeen with stable angina pectoris (SAP), ten with unstable angina pectoris (UAP), and seven patients who developed AMI during the study period. The enzyme variation in non-IHD delineates the background noise, and the increased variability in AMI indicates the full scale of the enzyme signals in cases of irreversible cell damage. Patients with SAP have the same enzyme signal as the background noise in respect of both CK and CK-B. However, in UAP the signal of CK-B equals the background noise, whereas the CK signal is separated from the latter. The reason may be that the signal to noise ratio of CK-B is poor and the analytical sensitivity low. Therefore, the behaviour of CK-B in this study does not support the above theory although our findings for CK indicate that the consequence of repeated ischaemic attacks is slight enzyme release.
重复性缺血发作可能具有累积效应，导致心肌细胞发生不可逆损伤并伴有酶释放。利用血浆肌酸激酶（CK）和肌酸激酶B亚基（CK-B）浓度，这一理论已在48例因急性胸痛入院但无急性心肌梗死（AMI）心电图征象的患者中得到验证。患者被分为四组：14例患有非缺血性心脏病（non-IHD），17例患有稳定型心绞痛（SAP），10例患有不稳定型心绞痛（UAP），7例在研究期间发生AMI。non-IHD组的酶变化描绘出背景噪声，而AMI组中酶变异性增加表明在不可逆细胞损伤情况下酶信号的全貌。SAP患者在CK和CK-B方面的酶信号与背景噪声相同。然而，在UAP中，CK-B的信号等于背景噪声，而CK信号与背景噪声分离。原因可能是CK-B的信噪比差且分析灵敏度低。因此，尽管我们关于CK的研究结果表明反复缺血发作的后果是轻微的酶释放，但本研究中CK-B的表现并不支持上述理论。
