Mair J, Wagner I, Jakob G, Lechleitner P, Dienstl F, Puschendorf B, Michel G
Department of Medical Chemistry, University of Innsbruck Medical School, Austria.
Clin Chim Acta. 1994 Nov;231(1):47-60. doi: 10.1016/0009-8981(94)90253-4.
For the first time we have compared time courses of cardiac myosin light chain-1 (MLC-1), beta-type myosin heavy chain (MHC), troponin T (TnT), myoglobin, creatine kinase (CK) and CKMB in the same patients with acute myocardial infarction (AMI). Blood samples were serially collected in 23 patients with first-time AMI. All but 3 patients received intravenous thrombolytic treatment. TnT and MLC-1 time courses were biphasic in most patients and showed two distinct peaks in 13 and 8 patients, respectively. MHC time courses were usually monophasic. Only 1 patient showed a biphasic MHC time course with two distinct peak values. Although MHC and MLC were lower by about the fourth day after onset of AMI in early reperfused patients, reperfusion did not qualitatively alter MLC and MHC release (no significant influence on the first appearance in blood or on time to peak). MLC and MHC peaks correlated closely (r = 0.75, P = 0.0001), whereas TnT peaks were correlated less closely with MLC or MHC peaks (r = 0.58 each, P < 0.007). Peak values of all cardiac contractile proteins correlated closely and significantly with CKMB peaks (0.75 < or = r < or = 0.81, P < or = 0.0006). Myoglobin was the first marker to increase in blood after AMI and showed the earliest peaks, whereas MHC increased latest showing the latest peaks. TnT increased significantly (P = 0.0001) earlier than MLC and MHC. These results can be explained by the impact of the intracellular compartmentation of a cardiac protein on the rapidity with which it is released after AMI.
我们首次在同一组急性心肌梗死（AMI）患者中比较了心肌肌球蛋白轻链-1（MLC-1）、β型肌球蛋白重链（MHC）、肌钙蛋白T（TnT）、肌红蛋白、肌酸激酶（CK）和CKMB的时间进程。对23例首次发生AMI的患者进行了系列血样采集。除3例患者外，其余患者均接受了静脉溶栓治疗。大多数患者的TnT和MLC-1时间进程呈双相性，分别有13例和8例患者出现两个明显的峰值。MHC时间进程通常为单相性。只有1例患者的MHC时间进程呈双相性，有两个明显的峰值。尽管在早期再灌注的AMI患者中，MHC和MLC在发病后约第4天时较低，但再灌注并未在质量上改变MLC和MHC的释放（对其首次出现在血液中的时间或达到峰值的时间无显著影响）。MLC和MHC峰值密切相关（r = 0.75，P = 0.0001），而TnT峰值与MLC或MHC峰值的相关性较弱（r均为0.58，P < 0.007）。所有心脏收缩蛋白的峰值均与CKMB峰值密切且显著相关（0.75≤r≤0.81，P≤0.0006）。肌红蛋白是AMI后血液中第一个升高的标志物，且峰值出现最早，而MHC升高最晚，峰值出现也最晚。TnT升高明显早于MLC和MHC（P = 0.0001）。这些结果可以通过心脏蛋白的细胞内区室化对AMI后其释放速度的影响来解释。
