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Postaggressionsstoffwechsel nach Herzinfarkt — dargestellt am Verhalten kurzlebiger Plasmaproteine

Stress-metabolism after myocardial infarction — demonstrated by means of the behaviour of plasma proteins with short half-life

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Summary

The kinetics of plasma proteins with short half-life during stress-metabolism in patients after myocardial infarction with and without clinical complications and after angina pectoris were compared. The acute-phase proteins α1-antitrypsin, C-reactive protein (CRP), fibrinogen, haptoglobin, and the transport proteins prealbumin and transferrin were analyzed with the method of radial immunodiffusion.

Whereas angina pectoris doesn't influence the protein kinetics, one can recognize after myocardial infarction a continuous increase of the acute-phase proteins to maxima between the 3rd and 5th day after the attack. Parallel to these changes, the transport proteins decrease with subsequent increase.

The changes, which are similar to those seen after surgical trauma, are dependent on the severity of illness, and can be used as prognostic parameters.

During stress metabolism, the concentrations of the proteins depending on nutrition, prealbumin and transferrin, are modified by the type and severity of stress, and by nutritional influences. The mechanisms of these changes and the consequences for their use as diagnostic parameters are discussed.

Zusammenfassung

Die Kinetik kurzlebiger Plasmaproteine im Postaggressionssyndrom wurde vergleichend bei Patienten nach Herzinfarkt (HI) mit und ohne klinische Komplikationen und nach Angina Pectoris-Anfall (AP) am Beispiel der Akut-Phase-Proteine α1-Antitrypsin, C-reaktives Protein, Fibrinogen und Haptoglobin sowie der Transportproteine Präalbumin und Transferrin nach der Methode der radialen Immundiffusion untersucht. Während AP keinen Einfluß auf die Proteinkinetik ausübt, zeigen sich nach HI ein kontinuierlicher Anstieg der Akut-Phase-Proteine und ein dazu parallel verlaufender Abfall der Transportproteine mit Maximal- bzw. Minimal-Konzentrationen zwischen dem 3. und 5. Tag nach dem Ereignis und anschließender Rückbildung zu den Ausgangswerten. Die Veränderungen, die in ähnlicher Weise auch nach chirurgischen Traumata beobachtet werden, sind abhängig vom Schweregrad der Erkrankung und entsprechend prognostisch verwertbar.

Im Postaggressionssyndrom wird demnach das Verhalten der nahrungsabhängigen Proteine Präalbumin und Transferrin sowohl durch Art und Stärke des Streßeinflusses als auch durch den Ernährungszustand beeinflußt. Der Mechanismus dieser Veränderungen und die Konsequenzen für die Verwendung der Proteine als diagnostische Kenngrößen werden diskutiert.

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Authors and Affiliations

  1. Abtlg. für Stoffwechsel und Ernährung, Carl-Korth-Institut für Herz-Kreislauf-Erkrankungen, Erlangen, Germany

    G. Ollenschläger & H. Gofferje

  2. Institut für Med. Statistik und Dokumentation der Universität Erlangen-Nürnberg, Germany

    L. Horbach & H. Prestele

  3. Zentrum für Chirurgie der Universität Gießen, Germany

    K. Schultis

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  1. G. Ollenschläger
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  2. H. Gofferje
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  3. L. Horbach
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  4. H. Prestele
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  5. K. Schultis
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Ollenschläger, G., Gofferje, H., Horbach, L. et al. Postaggressionsstoffwechsel nach Herzinfarkt — dargestellt am Verhalten kurzlebiger Plasmaproteine. Klin Wochenschr 59, 437–449 (1981). https://doi.org/10.1007/BF01695898

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