Döring V, Bleese N, Steiner D
Thoraxchir Vask Chir. 1978 Oct;26(5):331-5. doi: 10.1055/s-0028-1096648.
There is still controversy of the validity of elevated CK-MB serum activity in the diagnosis of perioperative myocardial infarction after open heart surgery. CK-MB activity was investigated using myocardial and skeletal muscle biopsies and in sera postoperatively in 192 patients. In biopsies CK-MB fraction of total myocardial CPK was 37%, the total-CPK activity of human skeletal muscles still shows a 5% fraction of CK-MB. There has to be more than 8% CK-MB fraction of total CPK-serum-activity to take this as evidence of myocardial damage. 3 h postoperatively enzymatic-immunologic CK-MB test is no longer interfered by enzymes derived from hemolyzed erythrocytes. In patients without signs of myocardial lesions postoperatively mean CK-MB-activity is 11 to 27 U/1 depending on the operative procedure performed. Activity levels exceeding 50 U/1 are almost evident of myocardial infarction. Elevated CK-MB-serum activity is a sensitive parameter for myocardial lesions overestimating an event of infarction. It is a helpful tool diagnosing perioperative myocardial infarction.
心脏直视手术后，血清肌酸激酶同工酶（CK-MB）活性升高在围手术期心肌梗死诊断中的有效性仍存在争议。对192例患者术后采用心肌和骨骼肌活检及血清检测CK-MB活性。活检中，心肌总肌酸磷酸激酶（CPK）中CK-MB的比例为37%，人类骨骼肌的总CPK活性中仍有5%为CK-MB。总CPK血清活性中CK-MB比例超过8%才能作为心肌损伤的证据。术后3小时，酶免疫法检测CK-MB不再受溶血红细胞来源的酶干扰。术后无心肌损伤迹象的患者，根据所施行的手术操作不同，CK-MB平均活性为11至27 U/1。活性水平超过50 U/1几乎可确诊心肌梗死。血清CK-MB活性升高是心肌损伤的敏感指标，但会高估梗死事件。它是诊断围手术期心肌梗死的有用工具。
