[Study on the change in serum enzyme activity during acute aortic dissection]

Cases of acute aortic dissection presenting to the First Department of Surgery at Toyama Medical and Pharmaceutical University Hospital were divided into 2 groups according to the presence or absence of complications such as electrocardiographic abnormalities, hepatic or renal dysfunction, intestinal necrosis, and leg ischemia. After hospitalization such complications were completely absent in the "complication-free group", but were present in the "complication group". Fluctuations in serum enzyme activity (CK, LDH, GOT, GPT) were measured, and the 2 groups compared. In the complication-free group, serum CK activity was significantly elevated at 273.3 +/- 154.5 IU/l, reaching a peak on the first day, after which it decreased to normal by the fourth day. In the complication group, fluctuations in the serum enzyme activity levels corresponded to the type of complication, with the fluctuations paralleling changes in the clinical course. Also, CK activity was measured in aortic wall specimens obtained at autopsy, and the CK activity of 585.0 +/- 35.3 IU/g protein demonstrated. From the above it was thought the transient elevation of serum CK activity found in uncomplicated aortic dissection is due to the CK released from the dissected aortic wall into blood.