Tanaka H, Abe S, Yamashita T, Arima S, Saigo M, Nakao S, Toda H, Nomoto K, Tahara M
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Coron Artery Dis. 1997 Jul;8(7):433-9. doi: 10.1097/00019501-199707000-00005.
Cardiac troponin I (TnI) and troponin T (TnT) are highly specific myocardial markers.
To determine whether their serum levels can be used to estimate myocardial infarct size soon after reperfusion.
We measured the serum levels of TnI, TnT, and creatine kinase every 3 h, and the serum cardiac myosin light chain I (MLCI) every 24 h, in 42 patients with acute myocardial infarction in whom reperfusion therapy had successfully been performed. We calculated the severity of regional hypokinesis by analyzing the follow-up ventriculograms with the centerline method.
The time from reperfusion to the peak level for TnI was 6.1 +/- 3.5 h, significantly shorter than those for creatine kinase (7.5 +/- 4.1 h) and MLCI (55 +/- 28 h). The time to peak level for TnT (6.8 +/- 4.0 h) differed significantly from that for MLCI but not from that for creatine kinase. There was a significant correlation between the peak levels of TnI and TnT (r = 0.86). The peak TnI and TnT levels were correlated well to the peak creatine kinase level (r = 0.67 and 0.69, respectively), total creatine kinase release (r = 0.66 and 0.66), and the peak MLCI level (r = 0.71 and 0.80). We observed excellent correlations between the peak levels of TnI and TnT, and regional hypokinesis (r = -0.84 and -0.85, respectively). These were comparable to the correlations between regional hypokinesis and the peak creatine kinase level (r = 0.75), total creatine kinase release (r = -0.72), and the peak MLCI level (r = -0.76).
These results suggest that the peak serum levels of TnI and TnT in patients with successful reperfusion are accurate and early indices of infarct size.
心肌肌钙蛋白I（TnI）和肌钙蛋白T（TnT）是高度特异性的心肌标志物。
确定再灌注后不久其血清水平是否可用于评估心肌梗死面积。
我们对42例成功进行再灌注治疗的急性心肌梗死患者，每3小时测量一次TnI、TnT和肌酸激酶的血清水平，每24小时测量一次血清心肌肌球蛋白轻链I（MLC1）。我们采用中心线法分析随访心室造影，计算局部运动减弱的严重程度。
TnI从再灌注到峰值水平的时间为6.1±3.5小时，明显短于肌酸激酶（7.5±4.1小时）和MLC1（55±28小时）。TnT达到峰值水平的时间（6.8±4.0小时）与MLC1有显著差异，但与肌酸激酶无显著差异。TnI和TnT的峰值水平之间存在显著相关性（r = 0.86）。TnI和TnT的峰值水平与肌酸激酶峰值水平（分别为r = 0.67和0.69）、肌酸激酶总释放量（r = 0.66和0.66）以及MLC1峰值水平（r = 0.71和0.80）密切相关。我们观察到TnI和TnT的峰值水平与局部运动减弱之间存在极好的相关性（分别为r = -0.84和-0.85）。这些相关性与局部运动减弱和肌酸激酶峰值水平（r = 0.75）、肌酸激酶总释放量（r = -0.72）以及MLC1峰值水平（r = -0.76）之间的相关性相当。
这些结果表明，再灌注成功患者的TnI和TnT血清峰值水平是梗死面积准确且早期的指标。
