Alterations in Serum Creatine Kinase and Lactate Dehydrogenase: METHODS

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Three groups of patients were studied. The first consisted of 15 patients who were admitted to the coronary care unit with electro­cardiographic evidence of acute transmural myocardial infarctions. These patients had serum samples drawn for isoenzyme analyses every eight hours starting with admission for the first 24 hours of their hospital course. Samples were then drawn daily for five days for isoenzyme analyses of both CK and LD. In the second group, 13 individuals who were to undergo elective aortobifemoral bypass grafts for either occlusive or aneurysmal disease were studied. These patients had normal preoperative ECGs and serum isoen­zyme analyses. Postoperatively, serum samples were collected for isoenzyme determinations in the recovery room and twice daily for three days. Samples were subsequently collected daily for an additional five days. During the first two postoperative days, the patients were monitored in the surgical intensive care unit and serial ECGs were performed daily. The third group of patients consisted of eight individuals with suspected bowel infarction. Confirmation of mesenteric infarction was obtained at operation or at autopsy in all cases. Enzyme determinations were drawn preop- eratively and postoperatively at least twice daily until both С К and LD returned to normal. These patients also had daily electrocar­diographic monitoring postoperatively to determine whether myo­cardial infarction had occurred. All blood samples were centrifuged for ten minutes at 3,000 rpm. Serum was extracted from each sample using standard pipettes. Serum total CK and LD were determined by automated spectrophotometry. Isoenzymes were determined using agarose gel electrophoresis. Results for each measurement were tabulated, compiled and graphed. Perceived differences were evaluated by the Wilcoxon rank-sum test to determine whether they were significant between groups. All values reported are values from the normal distribution reflecting an analysis of a one-sided test.

All patients voluntarily entered this prospective study which had been reviewed and passed by the Clinical Investigation and Human Use Committees of Walter Reed Army Medical Center. All signed consent forms approved by both committees and had the voluntary right to withdraw from the study at any time without incurring any changes in status or alteration in optimum medical care.
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