Kagen L, Scheidt S, Butt A
Am J Med. 1977 Jan;62(1):86-92. doi: 10.1016/0002-9343(77)90353-9.
When serum was sampled frequently and soon after acute myocardial infarction, myoglobinemia was extremely common, occurring in 12 of 13 selected patients. Myoglobin first appeared in the serum within a few hours after infarction, but not consistently earlier than creatine phosphokinase. The peak level of serum myoglobin was reached appreciably earlier than the peak values of serum creatine phosphokinase activity. Time of earliest myoglobin appearance in the serum, peak level of myoglobin measured, and duration of detectable myoglobin release all correlated poorly with clinical and biochemical estimates of severity of myocardial infarction. There was no correlation between myoglobin levels and infarct size as estimated from creatine phosphokinase kinetics. Myoglobin appeared in the serum in multiple short "staccato" bursts, or episodes, often lasting only one to two hours. The hypothesis is suggested that the pattern of myoglobin appearance is a reflection of the episodic nature of acute myocardial infarction. Although isolated myoglobin determination may not be useful at present, for quantification of total myocardial damage, its pattern of release may be a sensitive marker for studying the time course of infarction, and may be useful to evaluate therapeutic interventions designed to interrupt an ongoing syndrome of myocardial necrosis.
在急性心肌梗死后不久频繁采集血清时，肌红蛋白尿极为常见，13例选定患者中有12例出现。肌红蛋白在梗死后数小时内首次出现在血清中，但并不总是比肌酸磷酸激酶更早出现。血清肌红蛋白的峰值水平明显早于血清肌酸磷酸激酶活性的峰值。血清中最早出现肌红蛋白的时间、测得的肌红蛋白峰值水平以及可检测到的肌红蛋白释放持续时间与心肌梗死严重程度的临床和生化评估相关性均较差。根据肌酸磷酸激酶动力学估计，肌红蛋白水平与梗死面积之间无相关性。肌红蛋白以多次短暂的“断奏”式突发或发作形式出现在血清中，通常仅持续一至两小时。有人提出假说，肌红蛋白出现的模式反映了急性心肌梗死的发作性本质。虽然目前单独测定肌红蛋白可能没有用处，但对于量化总的心肌损伤而言，其释放模式可能是研究梗死时间进程的敏感标志物，并且可能有助于评估旨在中断正在进行的心肌坏死综合征的治疗干预措施。
