Yamamuro M, Takazawa K, Tahara M, Sasaguri S, Nukariya M, Hosoda Y
Department of Thoracic Surgery, Juntendo University, Tokyo, Japan.
Surg Today. 1995;25(3):222-5. doi: 10.1007/BF00311531.
The changes in myosin light chain I (MLC I) following aortocoronary bypass were studied in 31 patients and the curves of these changes were classified into three different patterns. A peak level of 14.7 +/- 1.54 ng/ml was seen in seven patients on postoperative day (POD) 2 which decreased suddenly to less than twice the normal value by POD 7 (group 1). Another 19 patients showed a peak level of 20.7 +/- 16.5 ng/ml on POD 5, which decreased slowly and was still high even by POD 7 (group 2). The remaining five patients developed only a slight increase in the MLC I level after the operation, with a peak value of 5.5 +/- 0.8 ng/ml (group 3). Creatine kinase myocardial band and glutamic oxaloacetic transaminase also remained low in this group. No correlation existed between the peak value of MLC I and the aortic cross-clamping time, or between the peak value of MLC I and the cardiopulmonary bypass time. Furthermore, the difference in cardiac output before and after the operation did not significantly differ among the three groups. These findings indicate that the measurement of MLC I is useful for diagnosing perioperative myocardial damage and may also be useful in the study of myocardial protection.
在31例患者中研究了主动脉冠状动脉搭桥术后肌球蛋白轻链I（MLC I）的变化，并将这些变化曲线分为三种不同模式。7例患者在术后第2天（POD 2）出现峰值水平为14.7±1.54 ng/ml，到POD 7时突然降至正常价值的两倍以下（第1组）。另外19例患者在POD 5时出现峰值水平为20.7±16.5 ng/ml，下降缓慢，即使到POD 7时仍很高（第2组）。其余5例患者术后MLC I水平仅略有升高，峰值为5.5±0.8 ng/ml（第3组）。该组肌酸激酶心肌带和谷草转氨酶也保持在低水平。MLC I的峰值与主动脉阻断时间之间或MLC I的峰值与体外循环时间之间均无相关性。此外，三组患者术前和术后的心输出量差异无统计学意义。这些发现表明，MLC I的测量有助于诊断围手术期心肌损伤，也可能有助于心肌保护的研究。
