Mair J, Genser N, Maier J, Lechleitner P, Dienstl F, Puschendorf B
Department of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.
Clin Chim Acta. 1997 Nov 28;267(2):239-45. doi: 10.1016/s0009-8981(97)00150-2.
Intracoronary thrombosis plays a key role in the pathogenesis of acute myocardial infarction (AMI), and the formation of an occlusive thrombus usually precedes the development of myocardial damage. Therefore we evaluated and compared the early sensitivities of thrombin-antithrombin III complex (TAT), D-dimer, myoglobin, creatine kinase (CK) MB mass concentration, and cardiac troponin T (cTnT) on admission to a coronary care unit (CCU) before heparin or thrombolytic therapy was started. We investigated 31 consecutive patients admitted to CCU for evolving AMI within 6 hours from the onset of infarct-related symptoms; the median delay from chest pain onset to CCU admission was 135 minutes. Of all biochemical markers tested TAT had the highest early sensitivity on admission to the CCU, and TAT was significantly more sensitive than cTnT, CKMB mass, myoglobin, and D-dimer. However, TAT increases give no information about the location of clot formation in the body, and the diagnosis of AMI must be subsequently verified by an increase in more cardiac specific proteins, such as troponins or CKMB.
冠状动脉内血栓形成在急性心肌梗死（AMI）发病机制中起关键作用，闭塞性血栓的形成通常先于心肌损伤的发生。因此，我们在开始肝素或溶栓治疗前，评估并比较了入住冠心病监护病房（CCU）时凝血酶 - 抗凝血酶III复合物（TAT）、D - 二聚体、肌红蛋白、肌酸激酶（CK）MB质量浓度和心肌肌钙蛋白T（cTnT）的早期敏感性。我们调查了31例因急性心肌梗死相关症状发作6小时内连续入住CCU的患者；从胸痛发作到入住CCU的中位延迟时间为135分钟。在所有检测的生化标志物中，TAT在入住CCU时具有最高的早期敏感性，且TAT比cTnT、CKMB质量、肌红蛋白和D - 二聚体显著更敏感。然而，TAT升高无法提供体内血栓形成位置的信息，AMI的诊断随后必须通过肌钙蛋白或CKMB等更多心脏特异性蛋白的升高来证实。
