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バイパス手術30例において心筋ミオシン軽鎖Ⅰ(軽鎖)の流出曲線を検討した.軽鎖の流出曲線は二峰性で,全例で大動脈遮断解除直後から急激に上昇し,解除から88±28分後に最大値(15.8±9.0ng/ml,T-peak)を示した.軽鎖の値はT-peak後に1.1±0.7時間の半減期で減少した.7例ではT-peak後にそのまま平均6時間で正常化した.術前後でTl-201心筋像や心電図の悪化は生じなかった.23例では9.2±5時間後に4.1±2.1ng/ml(min-LCI)まで減少した.この後3.3±1日に再び最大値(8.4±5.8ng/ml,M-peak,M-value)を示した.Tl-201心筋像の新たな欠損を6例で,心電図変化を20例で認めた.M-value=2.1min-LCI(r=0.74)であった.軽鎖の観点からは心筋保護中に心筋梗塞時に生じる心筋障害と異なる.障害が存在し,これは心筋壊死とは関係が少ないと考えられた.軽鎖の流出曲線より心筋保護の詳細な評価が可能と考えられた.
After cardiac operation plasma level of ventricular myosin light chainⅠ(LCI), determined with monoclonal antibodies to myosin fragment, were studied in 30 patients under bypass surgery to assess its possible role as a marker for perioperative myocardial injury. LCI rapidly increased and reached peak levels (15.8± 9.0 gn/ml; T-peak) at 88±28 minutes after aortic de-clamp (T-Time). Then LCI rapidly decreased with fast half-time disappearance (1.1±0.7 hours). In 7 out of 30 patients LCI improved to normal range and MB reached maximum levels (28.8±11.9 U/L) at 6.3±2.3 hours after declamp.
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