Bastecký J, Palicka V, Vávrová J, Ettlerová E, Wasyliwová V
I. interní klinika FN Hradec Králové.
Vnitr Lek. 1996 Aug;42(8):519-23.
The objective of the presentation was to assess changes of the troponin T level--a very sensitive indicator of cardiac muscle damage--in patients with acute myocardial infarction treated by fibrinolysis, and to assess differences in troponin T levels between patients with successful reperfusion and without reperfusion. The troponin T level was examined in 28 patients with acute myocardial infarction (AIM), incl. 22 (78.6%) where probably reperfusion occurred, as concluded from a maximal increase of CPK and CPK MB values within 12 hours. In six patients with a later rise of enzyme values treatment was considered as probably unsuccessful. In both groups of patients troponin T values increased, particularly markedly in the group with probable reperfusion, starting from the 3rd to the 18th hour after the onset of treatment, when the differences in troponin values between the two groups were statistically significant at the 1% and 1% level of significance. An early rise of the troponin T level suggests more rapid release of so-called free cytoplasmic troponin T in patients with successful reperfusion. From the 54th hour there is a statistically insignificant rise of troponin T level in the group of patients without probable reperfusion and it suggests a more marked release of so-called structurally linked troponin T in patients where reperfusion was not achieved. Consistent with these results, the mean maximal value of troponin T during the period of 3-24 hours after the onset of treatment is 2.37 times higher than a corresponding value during the period of 60-108 hours in the group with probable reperfusion and conversely in the group without probable reperfusion the troponin T value is 1.2 times higher during the period 60-108 hours after the onset of treatment.
本报告的目的是评估接受纤维蛋白溶解治疗的急性心肌梗死患者中肌钙蛋白T水平（一种非常敏感的心肌损伤指标）的变化，并评估成功再灌注患者与未再灌注患者之间肌钙蛋白T水平的差异。对28例急性心肌梗死（AIM）患者进行了肌钙蛋白T水平检测，其中包括22例（78.6%）根据12小时内CPK和CPK MB值的最大升高推断可能发生再灌注的患者。6例酶值后期升高的患者被认为治疗可能未成功。两组患者的肌钙蛋白T值均升高，在可能发生再灌注的组中升高尤为明显，从治疗开始后第3小时至第18小时，两组肌钙蛋白值差异在1%和1%的显著性水平上具有统计学意义。肌钙蛋白T水平早期升高表明成功再灌注的患者中所谓的游离细胞质肌钙蛋白T释放更快。在无可能再灌注的患者组中，从第54小时开始肌钙蛋白T水平有统计学上不显著的升高，这表明在未实现再灌注的患者中所谓的结构连接肌钙蛋白T释放更为明显。与这些结果一致，在可能发生再灌注的组中，治疗开始后3至24小时内肌钙蛋白T的平均最大值比60至108小时期间的相应值高2.37倍，相反，在无可能再灌注的组中，治疗开始后60至108小时期间肌钙蛋白T值高1.2倍。
