Grenadier E, Keidar S, Kahana L, Alpan G, Marmur A, Palant A
Am Heart J. 1983 Mar;105(3):408-16. doi: 10.1016/0002-8703(83)90357-5.
Frequent blood samples were drawn for determination of serum myoglobin, creatine phosphokinase (CPK), and the MB isoenzyme of CPK (CPK-MB) in patients with acute myocardial infarction (AMI). Significantly elevated levels of myoglobin were present 1.5 hours following onset of chest pain and predated elevations of CPK and CPK-MB by 3 hours. No evidence of the previously described "staccato" phenomenon was found. Due to very frequent blood sampling, a detailed picture of the evolution over time of the above indices was obtained. Significant differences were found in the biochemical profile of anterior wall infarction and diaphragmatic wall MI. A time-sensitivity curve (showing sensitivity of the assay at each time following onset of symptoms) was obtained for myoglobin, CPK, and CPK-MB. It appears that myoglobin is the most sensitive biochemical indicator of AMI in its early phase and since it decreases rapidly back to normal values, it can serve as an invaluable aid in the diagnosis of reinfarction and infarct extension. CPK-MB is a less sensitive indicator of MI but has the advantage of greater specificity.
对急性心肌梗死（AMI）患者频繁采集血样，以测定血清肌红蛋白、肌酸磷酸激酶（CPK）及其MB同工酶（CPK-MB）。胸痛发作后1.5小时，肌红蛋白水平显著升高，比CPK和CPK-MB升高提前3小时。未发现先前描述的“断续”现象。由于频繁采血，获得了上述指标随时间演变的详细情况。前壁梗死和膈壁心肌梗死的生化特征存在显著差异。获得了肌红蛋白、CPK和CPK-MB的时间敏感性曲线（显示症状发作后各时间点检测方法的敏感性）。看来肌红蛋白是AMI早期最敏感的生化指标，并且由于其迅速恢复正常，它可作为诊断再梗死和梗死扩展的宝贵辅助手段。CPK-MB是心肌梗死较不敏感的指标，但具有更高特异性的优势。
