Radioimmunologische Bestimmung von Human-Myoglobin in der Diagnostik des akuten Myokardinfarkts

Abstract

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 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.

Radioimmunoassay Procedure of Serum Myoglobin in Case of a Long-Term Tocolysis with β-Sympathomimetics

“…In a limited sense, it can be confirmed that the serum myo globin level is primarily higher than the described standard value in case of the following diseases: skeletal muscle damage, severe renal affection, where the secretion of the protein is delayed and elevated serum levels result. Furthermore, elevated values were observed in a traumatic rhabdomyolysis (12), a limitation which can be disregarded in the case in question.…”

“…According to corresponding statements of various authors (12,18,21) the myoglobin normally circulating in blood ranges between 6 and 85 ng/ml.…”

“…It was only due to the application of radioimmunological methods (10-12, 18, 2 1 ,2 4 ) that a test could be developed which is definitely reproducible with regard to its sensitivity, a test which can prove an even slight rise of the serum myoglobin level as indicator for a myocardial infarction or a myocardial necrosis, and this even before the rise of the CK, CK-MB and electrocardiogram alteration ( 12).…”

Myoglobin im Serum: Referenzwerte und Klinik

“…Bei Muskelzellnekrosen wird neben Enzymen wie Kreatinkinase oder Laktatdehydrogenase auch Myoglobin freigesetzt. Myoglobinämie und Myoglobinurie können mit spezifischen Methoden laborchemisch erfaßt werden (8,19). Klinische Bedeutung gewinnt die Bestimmung von Myoglobin im Serum insbesondere bei der Diagnostik des akuten Myokardinfarktes (8,9,11,12) sowie beim Nachweis toxischer oder traumatischer Rhabdomyolysen (20,21).…”

“…Myoglobinämie und Myoglobinurie können mit spezifischen Methoden laborchemisch erfaßt werden (8,19). Klinische Bedeutung gewinnt die Bestimmung von Myoglobin im Serum insbesondere bei der Diagnostik des akuten Myokardinfarktes (8,9,11,12) sowie beim Nachweis toxischer oder traumatischer Rhabdomyolysen (20,21). Obgleich seit Einführung eines spezifischen, sensitiven Radioimmunoassays (19) die Bestimmung von Serum-Myoglobin zunehmend in den Mittelpunkt klinischen Interesses rückt und zahlreiche klinische Untersuchungen bereits vorliegen (l, 27), fehlen bislang verläßliche Informationen über Verteilungscharakteristik und Normwertebereich von Serum-Myoglobin.…”