Summary
A radioimmunoassay was developed to determine serum myoglobin (SMb). 50 healthy persons showed values between 0 and 90 ng/ml. Serial tests of 10 patients following acute myocardial infarction or during angina pectoris (AP) indicated that SMb reached pathological values before CK and CK-MB (average 250±95 ng/ml at the time of hospitalisation which corresponds to 3.3±1.4 h after beginning of angina pectoris). At hospitalisation the simultaneously determined CK was within normal limits and reached pathological values only 6.2±1.9 h after the onset of angina. Maximum of SMb was 506±194 ng/ml occurring 8.8±2.8 h after the beginning of AP, maximum of CK was 905±475 mU/ml occurring 20.0±7.8 h after AP.
CK-MB and CK differed only slightly in their time course. One patient with severe AP had pathologically increased SMb values whilst all other enzymes were completely normal. Methodical and clinical results are discussed.
Zusammenfassung
Ein Radioimmunoassay zur Bestimmung von Serum-Myoglobin (SMb) wird vorgestellt. Bei 50 gesunden Probanden beträgt der Meßwertbereich 0–90 ng/ml. Serielle Bestimmungen an 10 Patienten mit akutem Myokardinfarkt beziehungsweise Angina pectoris (AP) zeigen, daß SMb bei Myokardinfarkt vor CK und CK-MB pathologische Werte erreicht (im Mittel 250±95 ng/ml bei stationärer Aufnahme 3,3±1,4 h nach AP-Beginn). Die gleichzeitig bestimmte NAC-aktivierte CK liegt zu diesem Zeitpunkt noch im Normbereich und erreicht pathologische Werte erst 6,2±1,9 h nach Schmerzbeginn. Der Peak des Serum-Myoglobins liegt mit 506±194 ng/ml 8,8±2,8 h, der der CK mit 905±475 mU/ml 20,0±7,8 h nach Anginabeginn.
CK-MB und CK unterscheiden sich im zeitlichen Verlauf nur unwesentlich. Ein Patient mit ausgeprägter AP hat bei sonst unauffälligem Enzymmuster pathologisch erhöhte SMb-Werte. Methodische und klinische Ergebnisse werden diskutiert.
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Unterstützt wurde diese Studie aus Mitteln der Deutschen Forschungsgemeinschaft, SFB 89
Wir danken Dr. Münscher, Behringwerke Marburg, für die freundliche Überlassung des Myoglobins und Dr. C. McIntosh sowie Dr. R. Ebert für Assistenz und Beratung
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Kaiser, H., Spaar, U., Sold, G. et al. Radioimmunologische Bestimmung von Human-Myoglobin in der Diagnostik des akuten Myokardinfarkts. Klin Wochenschr 57, 225–235 (1979). https://doi.org/10.1007/BF01477491
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DOI: https://doi.org/10.1007/BF01477491