I to the diagnosis of myocardial injury
In many of the clinical diagnosis AMI biochemical indexes, CK MB once considered a diagnosis "gold standard", has been used for many years. Along with the further study of cTnI, regardless of its specificity or sensitivity, CK MB status have suffered serious challenges. CTnI is considered to be the most good sure markers, and has gradually replace CK MB become the diagnosis of AMI "gold standard".
In all kinds of myocardial cell damage occurred in patients with coronary artery disease, and some of the patients with clinical performance may not fully comply with WHO about AMI diagnosis standard (unstable angina is one of them), but with some myocardial injury markers (such as cTnT) increases, this makes the myocardial cell damage detection of biomarkers of possible.CTnT and cTnI in after AMI (3 ~ 6 h) blood quickly raise concentration, its performance and CK MB (3 ~ 8 h) quite or earlier, but they specificity and sensitivity was significantly higher than the CK MB, and has a long diagnosis cTn window period (cTnI seven to 10 d, cTnT 10 ~ 14 d). The data show that for patients with acute chest pain cTn (with or without myocardial injury in the diagnosis and differential diagnosis is better than CK MB (20,).
Whether unstable angina pectoris or no Q wave of myocardial infarction patients, cTnI has prognostic diagnostic value. The unstable coronary artery disease follow-up of patients, found that assessment cTnI greater than 0.1 mg/L the patient's mortality rate is less than 0.1 mg/L cTnI patient mortality big more than three times. Therefore, any acute coronary artery disease patients and increased the cTn, shall be regarded as (22,; high risk.
II AMI fibrinolytic therapy after the pointer
Intravenous injection thrombolysis drug is in recent years commonly used AMI treatment, after the therapy judge whether appear reperfusion also become clinical doctors one important concern. Research shows that, if for troponin peak of the early appear, often appear that reperfusion, early coronary artery reperfusion the pointer CK MB, muscle red protein (Mgb), cTnT and cTnI in successful treatment of thrombosis after early dynamic comparative study shows, four markers in thrombolysis early dynamics released after basic similar, but, cTnT and cTnI at the risk of coronary artery 90 min reperfusion average index significant higher than CK MB and Mgb (24).
III to the perioperative myocardial infarction diagnosis
Coronary artery bypass surgery after the diagnosis of myocardial infarction in an important role in the heart surgery. CTn is perioperative myocardial infarction sensitive and specific markers, able to identify did not reach the conventional perioperative myocardial infarction judgment standard of tiny perioperative myocardial injury.
IV to the diagnosis of myocarditis
Compared with CK activity, myocarditis, cTnT because its relatively high serum assessment and long rise time, and has higher detection sensitivity, serum cTnT level can be used as the diagnosis of acute myocarditis markers (10).
V the relationship and kidney failure
Ischemic heart disease is late-stage renal patients to disease and one of the leading causes of death, accounting for about 40% of the total mortality; These ischemic heart disease patients, about 25% development for AMI. Therefore, in the clinical treatment of patients with advanced kidney disease, cardiovascular complications diagnosis is a vital problem. In a late kidney patient serum, cTnT and cTnI assessment of the differences. Late in cTnT rise of kidney disease may cause to have: detection method of the cross reaction; CTnT in skeletal muscle of the heavy expression; There are tiny myocardial injury. The second generation cTnT analysis not because cTnT late in the heavy expression of skeletal muscle kidney patients and produce false-positive, which ruled out analysis cross reaction. Research thinks, kidney patients serum in late cTnT increases may be due to some extent myocardial injuries (25).
VI hypothyroidism myocardial injury patients diagnosis
Hypothyroidism cause cholesterol, make the patient to get coronary artery disease and AMI. At the same time, hypothyroidism patients often cramps, muscle pain skeletal muscle injury symptoms, so, this kind of patient serum CK, CK MB level has different rate increases. At this time, cTn is hypothyroidism myocardial injury patients diagnosed with good markers.
VII the drug
CTn is also used to look at some of the pharmacological effects of drugs and the heart of the relationship between observational studies, understanding whether improve or aggravate myocardial ischemia phenomenon.
VIII the other
Such as heart transplantation rejection or acute cardiac failure, also often appear cTn increases CK MB no abnormal phenomenon (26).
Due to the sensitivity of the cTnI myocardial infarction and detection of high sensitivity, in the heart disease diagnosis and differential diagnosis of functions are becoming more and more attention by people, through to the detection cTnI can not only improve the diagnosis of myocardial injury and has greatly improved the efficiency of the treatment of patients, and encourage people to existing diagnosis and differential diagnosis of methodology to know, however, because of the related inspection standard still not united, as well as the inspection of the existence of numerous interference factors, so that in the scientific research and clinical application of certain limits still.
Article : From perlong medical (http://www.pl999.net)
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