Christenson R H, Ohman E M, Topol E J, O'Hanesian M A, Sigmon K N, Duh S H, Kereiakes D, Worley S J, George B S, Pizzo C K
Department of Pathology, University of Maryland School of Medicine, Baltimore 21201, USA.
Clin Chem. 1995 Jun;41(6 Pt 1):844-52.
Creatine kinase isoforms markers, including MB2 concentration, MB2/MB1 and MM3/MM1 ratios, and MT index (based on the "tissue" M subunits), were measured in serial specimens from 207 patients receiving thrombolytic therapy followed by acute angiography. The slope of release showed a significant relation (P < 0.05) between MB2 concentrations and patency, graded as TIMI 0 through TIMI 3; with regard to the precatheterization/baseline ratio, the MB2 concentrations, the MM3/MM1 ratio, and the MT index were all significantly related to graded patency (P < 0.004). Patients having patency graded as either TIMI 2/3 (Open) or TIMI 0/1 (Closed) showed highly significant differences (P < 0.03) in the slope of release and precatheterization/baseline ratio for all markers except the MB2/MB1 ratio. Defining Open as TIMI 3 and Closed as TIMI 0/1/2 showed very similar results. Despite these significant differences between the Open and Closed groups after thrombolytic therapy, none of the C index calculations (areas under ROC curves) for any of the isoform markers--either alone or combined--exceeded 0.70, suggesting that these markers have limited diagnostic utility for assessing patency.
在207例接受溶栓治疗并随后进行急性血管造影的患者的系列样本中，测量了肌酸激酶同工酶标志物，包括MB2浓度、MB2/MB1和MM3/MM1比值以及MT指数（基于“组织”M亚基）。释放斜率显示MB2浓度与通畅程度（TIMI 0至TIMI 3分级）之间存在显著关系（P<0.05）；就导管插入术前/基线比值而言，MB2浓度、MM3/MM1比值和MT指数均与分级通畅程度显著相关（P<0.004）。通畅程度分级为TIMI 2/3（开通）或TIMI 0/1（闭塞）的患者，除MB2/MB1比值外，所有标志物的释放斜率和导管插入术前/基线比值均存在高度显著差异（P<0.03）。将开通定义为TIMI 3，闭塞定义为TIMI 0/1/2显示出非常相似的结果。尽管溶栓治疗后开通组和闭塞组之间存在这些显著差异，但任何同工酶标志物单独或联合的C指数计算（ROC曲线下面积）均未超过0.70，这表明这些标志物在评估通畅程度方面的诊断效用有限。
