Collinson P O, Rosalki S B, Flather M, Wolman R, Evans T
Department of Chemical Pathology, Royal Free Hospital, School of Medicine, Hampstead, London, UK.
Ann Clin Biochem. 1988 Jul;25 ( Pt 4):376-82. doi: 10.1177/000456328802500409.
Serum samples from patients admitted to a coronary care unit with a history of acute chest pain suggestive of myocardial infarction in the previous 12 h were obtained on admission and at 6 and 12 h, thereafter. Creatine kinase (CK), CK-MB isoenzyme, CK-MM sub-bands, myoglobin, and lactate dehydrogenase (LD) isoenzymes were examined. Changes were evaluated in relation to the diagnosis obtained from clinical examination, serial electrocardiography and 'routine' cardiac enzymes (CK, aspartate transaminase and alpha-hydroxy butyrate dehydrogenase daily for 3 days following admission). The slope of the logarithms of CK, CK-MB activity and CK-MB concentration in the early post infarct period fully distinguished between infarct and non-infarct patients. Measurement of myoglobin and lactate dehydrogenase isoenzymes was less sensitive. Serial estimation of CK-MM sub-band patterns allowed the time from infarction to be estimated. Serial estimation of CK in the 12 h following admission can be substituted for conventional daily enzyme estimations for the diagnosis of acute myocardial infarction in patients with onset of chest pain within the previous 12 h. This could reduce laboratory and in-patient costs.
收集入住冠心病监护病房且在过去12小时内有提示心肌梗死的急性胸痛病史患者的血清样本，分别于入院时、入院后6小时和12小时采集。检测肌酸激酶（CK）、CK-MB同工酶、CK-MM亚带、肌红蛋白和乳酸脱氢酶（LD）同工酶。根据临床检查、系列心电图检查以及“常规”心脏酶（入院后连续3天每天检测CK、天冬氨酸转氨酶和α-羟丁酸脱氢酶）所做出的诊断来评估各项指标的变化。梗死早期CK、CK-MB活性及CK-MB浓度对数的斜率能够完全区分梗死患者和非梗死患者。肌红蛋白和乳酸脱氢酶同工酶的检测敏感性较低。对CK-MM亚带模式进行系列评估可估算梗死发生时间。对于胸痛发作在过去12小时内的患者，入院后12小时内对CK进行系列检测可替代常规的每日酶检测用于急性心肌梗死的诊断。这可降低实验室及住院费用。
