Uchino T, William-Olsson G, Ishimaru S, Furukawa K
Tokyo Medical College, Japan.
Kyobu Geka. 1994 Nov;47(12):965-9.
The purpose of the study was to test cardiac myosin light chain I (MLCI) and troponin T (TNT) as markers of myocardial damage after heart surgery. Forty-three patients undergoing cardiac surgery were arbitrarily divided into three groups according to the creatine kinase MB isoenzyme (CK-MB) levels and postoperative electrocardiogram (ECG) changes. Group 1: CK MB > 100 micrograms/l and Infarction pattern changes in ECG (Infarction): Group 2: CK-MB < 100 micrograms/l and no ECG changes (minimal myocardial damage). Group 3: CK-MB > 100 micrograms/l or non specific ECG changes (myocardial injury). MLCI levels showed strong correlations with TNT levels after the operation. The peak MLCI and TNT levels in group 1 were significantly higher than in group 2. The peak MLCI in group 1 was significantly higher than in group 3. TNT showed different patterns in the Infarction and Injury groups. The study showed that MLCI and TNT estimation could evaluate myocardial damage over several postoperative days. TNT estimation could identify myocardial damage earlier than MLCI, however MLCI could discriminate perioperative infarction better than TNT.
本研究的目的是检测心肌肌球蛋白轻链I(MLCI)和肌钙蛋白T(TNT)作为心脏手术后心肌损伤的标志物。43例接受心脏手术的患者根据肌酸激酶MB同工酶(CK-MB)水平和术后心电图(ECG)变化被随机分为三组。第1组:CK MB>100微克/升且心电图有梗死样改变(梗死);第2组:CK-MB<100微克/升且无心电图改变(最小心肌损伤);第3组:CK-MB>100微克/升或有非特异性心电图改变(心肌损伤)。术后MLCI水平与TNT水平显示出强相关性。第1组的MLCI和TNT峰值水平显著高于第2组。第1组的MLCI峰值显著高于第3组。TNT在梗死组和损伤组呈现不同模式。研究表明,MLCI和TNT测定可在术后数天评估心肌损伤。TNT测定比MLCI能更早识别心肌损伤,然而MLCI在区分围手术期梗死方面比TNT更好。