Tanaka T, Aoki K, Aizawa T, Katou K, Takanashi S, Huruta S
Cardiovascular Institute, Tokyo, Japan.
Kokyu To Junkan. 1993 May;41(5):451-7.
After cardiac operation plasma level of ventricular myosin light chain I (LCI), determined with monoclonal antibodies to myosin fragment, were studied in 30 patients under bypass surgery to assess its possible role as a marker for perioperative myocardial injury. LCI rapidly increased and reached peak levels (15.8 +/- 9.0 gn/ml; T-peak) at 88 +/- 28 minutes after aortic declamp (T-Time). Then LCI rapidly decreased with fast half-time disappearance (1.1 +/- 0.7 hours). In 7 out of 30 patients LCI improved to normal range and MB reached maximum levels (28.8 +/- 11.9 U/L) at 6.3 +/- 2.3 hours after declamp. No abnormal change was noted in ECG and no new defects were noted in T1-201 myocardial images. In the remaining 23 patients LCI decreased to minimum levels (4.1 +/- 2.1 ng/ml; min-LCI) at 9.2 +/- 5 hours (min-Time) and then gradually increased to peak levels (8.4 +/- 5.8 ng/ml; M-peak, M-value) on day 3.3 +/- 1.0 (M-Time). MB reached maximum level (77.6 +/- 82.4 U/L, p < 0.1) at 3.4 +/- 1.4 hours (p < 0.001). Good correlation was noted among min-LCI, min-Time, M-value and summation of daily value of LCI (omega(LCI)) x min-LCI = 5.7-0.17 min-Time (r = -0.42) and M-value = 2.1 min-LCT(r=0.74) and omega(LCI) = -9.6 + 6.1 M-value (r = -0.96). From the rapid appearance of LCI peak levels after aortic declamp it was concluded that LCI, accumulated during aortic clamp, was washed out by aortic declamp.(ABSTRACT TRUNCATED AT 250 WORDS)
在心脏手术后，对30例接受体外循环手术的患者，用针对肌球蛋白片段的单克隆抗体测定其血浆中心室肌球蛋白轻链I（LCI）水平，以评估其作为围手术期心肌损伤标志物的可能作用。LCI迅速升高，在主动脉钳夹松开（T-Time）后88±28分钟达到峰值水平（15.8±9.0μg/ml；T-peak）。然后LCI迅速下降，半衰期快速消失（1.1±0.7小时）。30例患者中有7例LCI恢复到正常范围，肌酸激酶同工酶（MB）在钳夹松开后6.3±2.3小时达到最高水平（28.8±11.9U/L）。心电图未发现异常变化，T1-201心肌图像未发现新的缺损。其余23例患者中，LCI在9.2±5小时（min-Time）降至最低水平（4.1±2.1ng/ml；min-LCI），然后在第3.3±1.0天（M-Time）逐渐升至峰值水平（8.4±5.8ng/ml；M-peak，M值）。MB在3.4±1.4小时达到最高水平（77.6±82.4U/L，p<0.1）（p<0.001）。min-LCI、min-Time、M值与LCI每日值总和（ω（LCI））之间存在良好相关性：ω（LCI）×min-LCI = 5.7 - 0.17min-Time（r = -0.42），M值 = 2.1min-LCT（r = 0.74），ω（LCI） = -9.6 + 6.1M值（r = -0.96）。从主动脉钳夹松开后LCI峰值水平迅速出现可得出结论，在主动脉钳夹期间积累的LCI在主动脉钳夹松开时被冲洗掉。（摘要截断于250字）
