Shahangian S, Ash K O, Wahlstrom N O, Warden G D, Saffle J R, Taylor A, Green L S
Clin Chem. 1984 Aug;30(8):1332-8.
Medical records of 53 burn and trauma patients were reviewed to assess the possibility of myocardial damage. Except for electrophoretically detectable creatine kinase MB isoenzyme, none showed evidence of myocardial injury. Lactate dehydrogenase isoenzyme tests, electrocardiograms, myocardial pyrophosphate scans, clinical course, and results of (two) autopsies were all negative for myocardial necrosis or ischemia. Types of patient, number, mean peak value (U/L) for serum creatine kinase, and ranges of percentage MB isoenzyme were as follows. Burns from direct electrical contact: 28, 16 600, 0-29; electrical flash or other thermal burns: 10, 4340, 0-22; blunt trauma (mostly from automobile accidents): 15, 3430, 0-18; myocardial infarction: 57, 1520, 4-46. Evidently creatine kinase MB isoenzyme is nonspecific in burn and trauma patients and should not be the only test result used to assess myocardial involvement.
回顾了53例烧伤和创伤患者的病历,以评估心肌损伤的可能性。除了通过电泳可检测到的肌酸激酶MB同工酶外,没有其他证据表明存在心肌损伤。乳酸脱氢酶同工酶检测、心电图、心肌焦磷酸盐扫描、临床病程以及(两例)尸检结果均未发现心肌坏死或缺血。患者类型、数量、血清肌酸激酶的平均峰值(U/L)以及MB同工酶百分比范围如下。直接电接触烧伤:28例,16600,0 - 29;电火花或其他热烧伤:10例,4340,0 - 22;钝性创伤(主要来自汽车事故):15例,3430,0 - 18;心肌梗死:57例,1520,4 - 46。显然,肌酸激酶MB同工酶在烧伤和创伤患者中是非特异性的,不应作为评估心肌受累情况的唯一检测结果。