Uchino T, Belboul A, el-Gatit A, Roberts D, Berglin E, William-Olsson G
Department of Thoracic and Cardiovascular Surgery, Sahlgrenska Hospital, University of Gothenburg, Sweden.
J Heart Lung Transplant. 1994 May-Jun;13(3):418-23.
The purpose of this study was to evaluate the cardiac damage by cardiac myosin light chain I after transplantation. This study included 30 patients who underwent cardiac operations and who were divided into three groups. These groups consisted of (1) control group, 15 valvular patients without coronary disease (no electrocardiography changes and creatine kinase MB isoenzyme of 100 micrograms/L or less); (2) infarction group, eight patients (six coronary bypass and two valvular patients with perioperative infarction pattern in the electrocardiography and creatine kinase MB isoenzyme of 100 micrograms/L or more; and (3) transplantation group, seven transplant patients (six heart and one heart-lung). The peak cardiac myosin light chain I value in the transplantation group (32.9 +/- 3.4 micrograms/L) was comparable to the infarction group (27.6 +/- 2.6 micrograms/L), and both of them were significantly higher than the control group (9.2 +/- 0.9 micrograms/L) (p < 0.01). Peak cardiac myosin light chain I levels in the control and transplantation groups correlated with the ischemic time (r = 0.48, p < 0.05 and r = 0.67, p < 0.05, respectively). The total dose of dopamine in the transplantation group correlated with the peak cardiac myosin light chain I (r = 0.67, p < 0.05), and with the cardiac myosin light chain I value on day 7 (r = 0.88, p < 0.01). This study suggests that circulating cardiac myosin light chain I estimations are useful to evaluate myocardial damage after transplantation during postoperative week 1.
本研究的目的是评估移植后心肌肌球蛋白轻链I对心脏的损伤。本研究纳入了30例行心脏手术的患者，并将其分为三组。这些组包括：(1)对照组，15例无冠心病的瓣膜病患者(无心电图改变，肌酸激酶MB同工酶≤100微克/升)；(2)梗死组，8例患者(6例行冠状动脉搭桥术，2例瓣膜病患者围手术期有梗死心电图表现，肌酸激酶MB同工酶≥100微克/升)；(3)移植组，7例移植患者(6例心脏移植，1例心肺联合移植)。移植组心肌肌球蛋白轻链I峰值(32.9±3.4微克/升)与梗死组(27.6±2.6微克/升)相当，且两者均显著高于对照组(9.2±0.9微克/升)(p<0.01)。对照组和移植组心肌肌球蛋白轻链I峰值与缺血时间相关(r分别为0.48，p<0.05和0.67，p<0.05)。移植组多巴胺总剂量与心肌肌球蛋白轻链I峰值相关(r=0.67，p<0.05)，与第7天的心肌肌球蛋白轻链I值相关(r=0.88，p<0.01)。本研究表明，术后第1周内，循环心肌肌球蛋白轻链I测定有助于评估移植后的心肌损伤。
