Mair J, Wagner I, Morass B, Fridrich L, Lechleitner P, Dienstl F, Calzolari C, Larue C, Puschendorf B
Institut für Medizinische Chemie & Biochemie, Universität Innsbruck, Austria.
Eur J Clin Chem Clin Biochem. 1995 Nov;33(11):869-72.
Cardiac troponin I, creatine kinase, and creatine kinase MB activity were tested in serial blood samples from 15 patients with first-time Q wave acute myocardial infarction (2 anterior and 13 inferior wall infarctions). All patients received intravenous thrombolytic therapy. Cardiac troponin I and creatine kinase MB activity were compared with scintigraphic estimates of myocardial scar (single photon emission computed tomography [SPECT] with 99mTechnetium-isonitrile [Tc-sestamibi]) on late images at rest about 5 weeks after myocardial infarction. Scintigraphic defect sizes ranged from 3.2 to 41.2% (median: 27.3%) of left ventricle. Cardiac troponin I increased and peaked in parallel with creatine kinase MB activity, and the peak values correlated with each other (r = 0.76, p = 0.002). Troponin I stayed increased for several days longer than creatine kinase and creatine kinase MB activity. It could be detected at least until the 4th day after admission. Significant correlation coefficients were found between 99mTc-isonitrile defect sizes and areas under cardiac troponin I curves (r = 0.53, p = 0.042) and between 99mTc-isonitrile defect sizes and cumulative creatine kinase MB activity release (r = 0.64, p = 0.01). Animal studies have already shown a very close correlation between histologic infarct size and SPECT 99mTc-isonitrile defect size. Therefore, our results indicate that cardiac troponin I release in patients with acute myocardial infarction is also correlated with infarct size.
对15例首次发生Q波型急性心肌梗死患者（2例前壁梗死和13例下壁梗死）的系列血样进行了心肌肌钙蛋白I、肌酸激酶及肌酸激酶同工酶MB活性检测。所有患者均接受了静脉溶栓治疗。在心肌梗死后约5周的静息晚期图像上，将心肌肌钙蛋白I和肌酸激酶同工酶MB活性与心肌瘢痕的闪烁扫描估计值（采用锝-异腈酸盐[锝- sestamibi]的单光子发射计算机断层扫描[SPECT]）进行比较。闪烁扫描缺损大小范围为左心室的3.2%至41.2%（中位数：27.3%）。心肌肌钙蛋白I与肌酸激酶同工酶MB活性同时升高并达到峰值，且峰值相互相关（r = 0.76，p = 0.002）。肌钙蛋白I升高的持续时间比肌酸激酶和肌酸激酶同工酶MB活性长几天。入院后至少第4天仍可检测到。锝-异腈酸盐缺损大小与心肌肌钙蛋白I曲线下面积之间（r = 0.53，p = 0.042）以及锝-异腈酸盐缺损大小与肌酸激酶同工酶MB活性累积释放量之间（r = 0.64，p = 0.01）均发现显著相关系数。动物研究已表明组织学梗死大小与SPECT锝-异腈酸盐缺损大小之间存在非常密切的相关性。因此，我们的结果表明急性心肌梗死患者的心肌肌钙蛋白I释放也与梗死大小相关。
