二尖瓣置换术患者血清及心脏和骨骼肌CK-MB含量。

European journal of cardiology Pub Date : 1980-01-01
R Bendz, S Ström, C Olin
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引用次数: 0

摘要

研究了连续25例接受分离二尖瓣置换术(Björk—Shiley假体)的患者血清总肌酸激酶(CK)及其更具有心脏特异性的同工酶CK- mb的催化浓度。测定10例心脏和骨骼肌CK和CK- mb含量。术后血清CK-MB水平不反映患者间心肌CK-MB含量的差异。峰值血清CK- mb占总CK的百分比(16 +/- 1%)(平均+/- SEM)与心肌CK- mb的百分比(乳头肌20.9 +/- 1.3%,右耳18.2 +/- 0.5%)相似。所有检查的骨骼肌样本中都存在一小部分CK- mb(膈肌4.2 +/- 0.6%,腹直肌0.4 +/- 0.1%),这表明在试图确定术后血清CK- mb活性升高的原因时,还应考虑总CK水平。术后CK-MB升高程度与手术时间和主动脉交叉夹持时间有关。1例患者围手术期发生心肌梗死,该患者血清CK-MB动力学与其他患者不同,具有双相酶曲线。
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CK-MB in serum and in heart and skeletal muscles in patients subjected to mitral valve replacement.

Serum catalytic concentrations of total creatine kinase (CK) and its more heart-specific isoenzyme CK-MB were studied in 25 consecutive patients subjected to isolated mitral valve replacement (Björk--Shiley prosthesis). Heart and skeletal muscle CK and CK-MB content was determined in 10 cases. The postoperative serum levels did not reflect differences in myocardial CK-MB content between patients. CK-MB as a percentage of total CK at peak serum CK-MB (16 +/- 1%) (mean +/- SEM) was of similar order as the percentage of CK-MB in the myocardium (papillary muscle 20.9 +/- 1.3%, right auricle 18.2 +/- 0.5%). A small proportion of CK-MB was present in all skeletal muscle samples examined (diaphragm 4.2 +/- 0.6%, rectus abdominis 0.4 +/- 0.1%), indicating that the total CK level should also be taken into account in attempts to determine the origin of a raised postoperative serum CK-MB activity. The degree of postoperative CK-MB elevation was related to the duration of operation and of aortic cross-clamping. Perioperative myocardial infarction occurred in one patient, and serum CK-MB kinetics in this patient, with a biphasic enzyme curve, differed from those in the other patients.

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