血清肌红蛋白动态变化对急性心肌梗死病人冠脉再通的诊断价值

①目的探讨血清肌红蛋白是否可作为判断急性心肌梗死(AMI)再灌注的一个早期指标.②方法测定44例急性心肌梗死病人溶栓治疗前后血清肌红蛋白和CK-MB水平.采用双抗体法检测血清肌红蛋白,酶联耦合法检测血清CK-MB.③结果再灌注组肌红蛋白上升速度快,酶峰出现在发病后(5.53士1.19)h,而未灌注组肌红蛋白上升速度缓慢,酶峰出现在发病后(10.00±1.59)h.两组肌红蛋白酶峰出现时间比较有显著差异(t=9.37,P＜0.001).再灌注组CK-MB活性峰值出现在发病后(13.00±1.36)h,未灌注组CK-MB活性峰值出现在发病后(22.86±1.87)h,两组比较有显著差异(t=17.67,P＜0.001).再灌注组肌红蛋白酶峰前移的灵敏度为90.3%,特异度为84.6%.再灌注组CK-MB活性峰值前移的灵敏度为90.0%,特异度为80.2%.再灌注组肌红蛋白酶峰与CK-MB活性峰值出现时间比较也有显著差异(t=22.67,P＜0.001),但二者酶峰前移的灵敏度和特异度比较,差异均无显著性(x2=0.002,0.157,P＞0.05).④结论血清肌红蛋白可作为判断急性心肌梗死病人冠脉再通的一个早期指标.     

补阳还五汤对窒息型大鼠心肺复苏后心肌损伤的影响

目的:观察补阳还五汤(BHD)对窒息型大鼠心肺复苏后心肌损伤的影响.方法:成年雄性SD大鼠24只,随机分为假手术对照组、复苏组、BHD组,每组8只.建立窒息型大鼠心肺复苏模型,测定复苏后早期左心室血流动力学指标,并于复苏24h取样,检测血清心肌酶变化.结果:与假手术对照组比较,复苏组和BHD组大鼠心率在自主循环恢复(ROSC)后0.5h、1h和2h均明显下降(P<0.01),左心室收缩压(LVSP)在ROSC后0.5h和1h明显下降(P<0.01),左心室舒张末压(LVEDP)在ROSC即刻和0.5h明显上升(P<0.01或P<0.05),左室内压的最大上升速率(+dp/dt?max)在ROSC后0.5h、1h和2h均明显下降(P<0.01或 P<0.05),左室内压的最大下降速率(-dp/dtmax)在ROSC后0.5h、1h和2h均明显下降(P<0.01或P<0.05).与复苏组各时间点比较,BHD组心率、LVSP、LVEDP、+dp/dtmax和-dp/dtmax变化差异均无统计学意义(P>0.05).与假手术对照组比较,复苏组和BHD组大鼠的血清CK-MB和cTnI均显著升高(P<0.01);与复苏组比较, BHD组血清CK-MB和cTnI浓度明显降低(P<0.01).结论:窒息型大鼠心肺复苏早期出现心肌血流动力学指标和生化指标的异常,心肌收缩、舒张功能受损.补阳还五汤不能直接改善血流动力学,但能降低心肌酶学水平,减轻心肌细胞损伤.     

Clinical implications of LDH isoenzymes in hemolysis and continuous-flow left ventricular assist device-induced thrombosis

Pump-induced thrombosis continues to be a major complication of continuous-flow left ventricular assist devices (CF-LVADs), which increases the risks of thromboembolic stroke, peripheral thromboembolism, reduced pump flow, pump failure, cardiogenic shock, and death. This is confounded by the fact that there is currently no direct measure for a proper diagnosis during pump support. Given the severity of this complication and its required treatment, the ability to accurately differentiate CF-LVAD pump thrombosis from other complications is vital. Hemolysis measured by elevated lactate dehydrogenase (LDH) enzyme levels, when there is clinical suspicion of pump-induced thrombosis, is currently accepted as an important metric used by clinicians for diagnosis; however, LDH is a relatively nonspecific finding. LDH exists as five isoenzymes in the body, each with a unique tissue distribution. CF-LVAD pump thrombosis has been associated with elevated serum LDH-1 and LDH-2, as well as decreased LDH-4 and LDH-5. Herein, we review the various isoenzymes of LDH and their utility in differentiating hemolysis seen in CF-LVAD pump thrombosis from other physiologic and pathologic conditions as reported in the literature.     

旋毛虫不同发育阶段同工酶的电泳分析

目的　通过对旋毛虫不同发育阶段同工酶酶谱变化的研究 ,以探讨其生物发育过程中的一些规律。　方法　应用聚丙烯酰胺凝胶电泳 (PAGE)和 UVP凝胶分析仪对猪型黑龙江株旋毛虫成虫、肌肉期幼虫和新生幼虫的酯酶同工酶(EST)、乳酸脱氢酶同工酶 (L DH)、苹果酸脱氢酶同工酶 (MDH)、延胡索酸酶同工酶 (MUF)进行分析。　结果　 3个发育时期的 MDH、EST酶谱基本相似 ;L DH的酶谱虽均有 1条带 ,但新生幼虫最深 ,肌肉期幼虫最浅 ;MUF酶谱新生幼虫最深 ,成虫较浅 ,肌肉期幼虫未见酶带。　结论　旋毛虫发育过程中 MDH、EST同工酶变化较小 ,但是 L DH、MUF同工酶存在较大差异     

Alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) activity in the sera of patients with liver cancer

The principal enzymes catalyzing the conversion of ethanol to acetate are alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). The activities of these enzymes are elevated in the serum during the course of alcoholism or cirrhosis. In previous investigations we have found elevated levels of ADH, ALDH, and class I ADH activity in liver cancer cells. It can suggest that these changes may be reflected by enzyme activity in the serum. In this work, the activity of ADH isoenzymes, and ALDH in the sera of patients with liver cancer was measured. Serum samples were taken from 64 patients (28 drinkers, 36 nondrinkers), with liver cancer. 25 patients had primary and 39 metastatic liver tumors. Total ADH activity was measured by photometric method with p-nitrosodimethylaniline (NDMA) as a substrate and ALDH activity by the fluorimetric method with 6-methoxy-2-naphtaldehyde as a substrate. For the measurement of the activity of class I and II isoenzymes we employed the fluorimetric methods, with class-specific fluorogenic substrates. The activity of class III ADH was measured by the photometric method with formaldehyde and class IV with m-nitrobenzaldehyde as a substrate. A statistically significant increase of class I ADH isoenzymes was found in the sera of cancer patients. The median activity of this class isoenzyme in the total cancer group increased about 51% (2.94 mU/L) in the comparison to the control level (1.43 mU/L). The activity of the class I ADH isoenzyme was significantly higher in the sera of patients with metastatic tumors than with primary cancers. The activity of this class in the sera of drinkers and group of moderate drinkers was significantly higher in comparison to the control group and higher in the sera of heavy drinkers when compared with moderate drinking patients. The total ADH activity was significantly higher (44%) among patients with cancer than healthy ones. The activity of class I ADH isoenzymes was elevated only in the serum of patients with metastatic liver cancer. This increase of activity seems to be caused by the enzyme released from liver cancer cells and primary tumors originating in other organs.     

免疫抑制法测定AST线粒体同工酶及其与慢性肝炎、重症肝炎的相关性

目的建立免疫抑制法检测血清AST线粒体同工酶(m-AST)活性,了解血清m-AST活性与肝脏病变程度之间的关系。方法82例正常人、33例慢性肝炎(CH)、19例重型肝炎(FH)病人血清用免疫抑制法和速率法分别测定m-AST和AST总酶活力,算出m-AST/AST比值。结果本法标准曲线y=1.088x-8.889,r=0.999。精密度试验结果为批内CV<3.71%、批间CV<3.91%、回收率96.3～104.6%,平均值100.5%。82例正常血清标本m-AST值和m-AST/AST比值分别为1.1±0.4U/L和5.7±1.8%,33例慢性肝炎血清标本分别为82.6±30.9U/L和26.1±22.5%,19例重型肝炎血清标本分别为152.9±29.5U/L和30.5±25.2%,与正常组比较均有显著性差异(P<0.01)。慢性肝炎和重型肝炎血清标本之间m-AST值和m-AST/AST比值也有显著性差异(P<0.01)。结论免疫抑制法测定血清m-AST方法简单、快速、重复性好,还可间接反映肝细胞损伤的严重程度。     

Metabolic and Biochemical Responses of the Healthy Human Lung to Nonthoracic Surgery

The objective of this study was to evaluate and assign numbers to biochemical or cellular entities in lung-healthy patients that change immediately postsurgery compared with the same parameters immediately presurgery, with the hypothesis that biochemical markers with significant change could be the basis of tests to predict postoperative respiratory complications. Thirty lung-healthy adults who were to undergo elective surgical procedures requiring general anesthesia participated. The population included sequential persons that met inclusion criteria and gave consent. At intubation and before surgery, a bonchoalveolar lavage (BAL) was performed. Before extubation but after completion of surgical procedures, a second 100-ml BAL was performed in the contralateral lung. Serum from both time periods was also collected. Total cell counts were elevated postsurgery in smokers and subjects claiming childhood but not current asthma, who also showed increased postsurgical BAL IL-1 but not increased TNFα. LDH and its isoenzymes, measured in both BAL and serum, showed no correlation with time on surgical ventilation, average FiO₂, or average peak pressure during surgical ventilation. BAL LDH isoenzyme 4 showed a significant elevation pattern pre-to-post surgery when the entire subject population was considered irrespective of surgery type or time on ventilation. Presurgery versus postsurgery variation was best measured in BAL rather than in serum. The pulmonary, biochemical, and cellular parameters measured in the pre- and postsurgical BALs of lung-healthy subjects undergoing nonthoracic surgery show subtle modulations of pulmonary defense markers, defined by significantly increased proinflammatory cytokines and cell counts postsurgery compared to the same patient presurgery.     

Altered distribution of myosin isoenzymes in the cardiomyopathic Syrian hamster (BIO 8.262)

Summary Myosin of the ventricular myocardium of the cardiomyopathic Syrian hamster and of control animals was analysed using non-dissociating pyrophosphate electrophoresis. Three different myosin isoenzymes exhibiting different Ca²⁺ activated ATPase activities were demonstrated in the ventricular myocardium of the Syrian hamster. As shown by peptide mapping, ventricular myosin isoenzymes differ in their heavy chain composition. In the cardiomyopathic hamster a shift to myosins of lower Ca²⁺-activated ATPase activities occurs in the stage of insufficiency (age 220 days), whereas no different isoenzyme pattern could be found at the age of 65 days compared to control animals. We conclude that this redistribution of myosin isoenzymes is the basis of reduced myosin ATPase activity in the ventricular myocardium of the cardiomyopathic Syrian hamster during the development of myocardial insufficiency.Supported by the SFB 89, Göttingen     

已婚妇女宫颈组织乳酸脱氢酶(LDH)及其同工酶谱的观察

应用聚丙稀酰胺圆盘凝胶电泳法观察到已婚妇女正常宫颈组织和宫颈癌组织LDH同工酶谱基本相同,唯正常组织和癌组织的同工酶含量有所不同,癌组织中LDH_4增加;两类宫颈组织的LDH_3均为双带,酷似两种同工酶(即于LDH_2和LDH_3之间有一额外区带,其电泳行为更接近于LDH_3)。应用二硝基苯肼法测得宫颈癌组织LDH总酶活性大于正常相应组织,其差别有高度显著性(P<0.001)。维族和汉族正常宫颈组织LDH总酶活性差别无显著性。