Grande P, Christiansen C, Alstrup K
Clin Chim Acta. 1983 Mar 14;128(2-3):329-35. doi: 10.1016/0009-8981(83)90332-7.
The purpose of this study was to set up a simple and reliable procedure for estimating acute myocardial infarct (AMI) size by measuring serum enzymes in a few daily blood samples. Peak enzyme values and estimated infarct size from one, two, or three daily samples of aspartate aminotransferase (ASAT), creatine kinase (CK), CK-MB, and lactate dehydrogenase (LD) were compared with the extent of myocardial necrosis measured at autopsy in 22 patients who died from AMI. The correlation between the extent of the necrosis measured and peak serum enzymes from one daily blood sample was highest for CK-MB (r = 0.78) and LD (r = 0.73) compared to CK (r = 0.68) and ASAT (r = 0.67). To obtain a significant correlation, however, two patients had to be excluded from the ASAT and LD analyses. No significant improvement was obtained by more frequent blood sampling. Estimation of infarct size did not improve the correlation significantly for any enzyme, although the coefficient of correlation for CK-MB increased slightly (r = 0.83). Serum CK-MB determination provides a semiquantitative estimate of infarct size, but the other enzymes may give erroneous estimates owing to lesser cardiospecificity.
本研究的目的是建立一种简单可靠的方法，通过检测每日采集的少量血样中的血清酶来估算急性心肌梗死（AMI）面积。将天冬氨酸转氨酶（ASAT）、肌酸激酶（CK）、CK-MB和乳酸脱氢酶（LD）每日一次、两次或三次血样的酶峰值及估算的梗死面积，与22例死于AMI患者尸检时测得的心肌坏死范围进行比较。与CK（r = 0.68）和ASAT（r = 0.67）相比，CK-MB（r = 0.78）和LD（r = 0.73）的每日一次血样测得的坏死范围与血清酶峰值之间的相关性最高。然而，为了获得显著相关性，必须将两名患者排除在ASAT和LD分析之外。更频繁地采集血样并未显著改善相关性。梗死面积的估算对任何一种酶而言均未显著提高相关性，尽管CK-MB的相关系数略有增加（r = 0.83）。血清CK-MB测定可提供梗死面积的半定量估算，但其他酶由于心肌特异性较低可能会给出错误的估算结果。
