血清肌型烯醇化酶放免实验与临床意义

Serum Muscle-specific Enolase lmmunoradioassay and Clinic Significance

烯醇化酶是由三个免疫学上性质不同的亚基（α，β和γ）组成的糖酵解酶。β－烯醇化酶（αβ和ββ）存在于骨骼肌和心肌组织，是肌肉特异烯醇化酶（Ｍｕｓｃｌｅ－ｓｐｅｃｉｆｉｃｅｎｏｌａｓｅ，ＭＳＥ），它催化２－磷酸甘油酸成为磷酸烯醇式丙酮酸。我们建立了ＭＳＥ放免实验测定法（ＲＩＡ）并用于检测肌病和急性心肌梗塞（ＡＭＩ）患者血清ＭＳＥ水平，并观察了血清ＭＳＥ与肌酸激酶（ＣＫ）和肌红蛋白（Ｍｂ的相关性。实验结果显示：ＡＭＩ和肌病患者血清ＭＳＥ水平明显升高，正常值为２３．９±１０．９μｇ／Ｌ，肌病为２４９．４±２０３．１μｇ／Ｌ和ＡＭＩ为２７３．９±２０６．７μｇ／Ｌ。在这些患者中ＣＫ和Ｍｂ也明显升高并与ＭＳＥ有很好的相关性（ＣＫ，ｒ＝０，８７８；Ｍｂ，ｒ＝０．６１９）。实验结果表明血清ＭＳＥ可作为肌病及ＡＭＩ特异诊断指标。

Enolase is a dimeric enzyme comprised of three different subunitg α、βandγ.β─enolase is primarily located in skeletal and cardiac muscle as ββand αβ enolase (musclespecle specific enolase,MSE),Enolase is a glycolytic enzyme catalyzing the reaction pathwaybetween 2-phosphoglycerate and phosphoenopyruvate.In our laboratory,a immunoradioassay hasbeen developed for MSE estimation and used to measure serum MSE levels in patients with muscle disease and acute myocardial infarction(AMI).The control value of serum MSE was 23.9±10.9μg/1.The levels of MSE in AMI and muscle disease were 273.9 ±206.7μg/1 and 249,4±203.1μ g/1,respectively.The results showed that serum MSE level was strikingly increased inAMI and muscle diseases.The levels of serum creatine kinase(CK)and myoglobin (Mb)werealso examined and the results showed that CK and Mb levels also increased in the two groups.There was a higher correlation in serum levels of MSE than that of CK and Mb(r=0.878,r=0.619,respectively).The above results indicated that serum MSE might will be a specific mar-ker in diagnosis of muscle disease and AMI.