血清肌酸激酶同工酶MM(CK-MM)亚带动态测定诊断急性心肌梗塞

Serial determination of serum isoforms of creatine kinase MM（CK-MM） isoenzyme in the diagnosis of acute myocardial infarction（AMI）

摘要: 本文观察了12例急性心肌梗塞（AMI）患者血清CK,CK-MB,CK-MM及亚带的动态变化。结果表明:血清CK-MM亚带MM₃/MM₁比值在梗塞发生后2h内即出现异常（P<0.05）,平均3.5h开始升高,幅度为基础值的9—33倍,约10h达峰值,早于CK和CK-MB。血清MM₃峰值与CK,CK-MB和CK-MM峰值及相应累积释放(∫₀^Tf（t）·d_t)均呈显著正相关（P<0.01）。另外还比较了各同I酶Ka和Kd值大小,表明MM₃和CK-MB最大,MM₁最小。这提示血清CK-MM亚带MM₃/MM₁比值是AMI早期诊断的最敏感指标,动态测定CK-MM亚带亦有助于估计AMI的预后和了解心肌酶的释放情况。

Abstract: Using electrophoretic method, the changes of three CK-MM isoiorms in the serum of 12AMI patients were monitored for 3 days. In post-AMI period, MM₃ reached a peak first （518.6u/l）, 14.0h after infarction, followed by MM₂（19.8h, 640.5u/l） and MM₁（28.7h, 641.3u/l）. The MM₃/MM₁ ratio raised beyond the upper limit found in healthy subiects, about 3.5 h after the onset of symptom and peaks 10.6h after AMI, even earier than the peaks of isoforms, CK and CK-MB. Thus the MM₃/MM₁ ratio is an earlier and more sensitive indicator of AMI.