Matrix Metalloproteinase-9 vs. Troponin T
Matrix Metalloproteinase-9 vs. Troponin T
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基质金属蛋白酶 9 与肌钙蛋白 T
DOI：
10.1253/circj.cj-11-1139
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发表时间：
2011
期刊：
影响因子：
37.8
通讯作者：
W. Kong
中科院分区：
文献类型：
--
作者：
W. Kong
急性冠脉综合征（ACS）的早期检测对患者非常重要，因为及时干预后可获得预后益处。1当ECG不确定时，对急诊医生来说尤其具有挑战性，因此在过去20年中，特异性、敏感性和成本效益高的生物标志物已成为ACS有前途的补充诊断工具。2测量心肌肌钙蛋白、利钠肽、肌酸激酶-心肌结合的和C-反应蛋白（CRP）水平已经被完全纳入临床护理多年。3 -5其中，心肌肌钙蛋白（cTn）被认为是“金标准”生物标志物，因为其心肌组织特异性和敏感性，以及其对治疗决策的确定有用性。6然而，即使是目前的肌钙蛋白测定也有一定的局限性。7首先，当肌细胞发生损伤时，cTn被释放到循环中。因此，它对心脏损伤有特异性，但心肌缺血对ACS无特异性。肺栓塞、高血压急症或脓毒症患者血浆肌钙蛋白水平可能升高。过度依赖肌钙蛋白可能会误导进一步的诊断和治疗。其次，标准肌钙蛋白测定的最大灵敏度直到心肌坏死开始后6小时或更长时间才达到，这表明其对于ACS的早期检测的灵敏度不足。最近，正在开发新一代的高灵敏度肌钙蛋白检测试剂盒来克服这一限制。7然而，新的检测试剂盒在表面健康的人或未最终诊断为ACS的患者中显示出低水平的cTn呈阳性。总之，这些结果突出了开发专门针对早期ACS的互补生物标志物的重要性。
arly detection of acute coronary syndrome (ACS) is extremely important for patients because of the prognostic benefit following timely intervention.1 It’s particularly challenging for the emergency physician when the ECG is inconclusive, so specific, sensitive and cost-effective biomarkers have appeared as a promising supplemental diagnostic tool for ACS in the past 2 decades.2 Measurement of cardiac troponin, natriuretic peptides, creatine kinase-myocardial bound, and C-reactive protein (CRP) levels has been fully incorporated into clinical care for many years.3–5 Of them, cardiac troponin (cTn) is considered to be the “gold standard” biomarker because of its myocardial tissue specificity and sensitivity, as well as its established usefulness for therapeutic decision-making.6 However, even current generation troponin assays have certain limitations.7 Firstly, cTn is released into the circulation when damage to the myocyte has occurred. Therefore, it is specific for cardiac injury, but myocardial ischemia is not specific for ACS. Patients with pulmonary embolism, hypertensive emergency or sepsis can have an increased level of plasma troponin. Over-reliance on troponin may mislead the further diagnosis and treatment. Secondly, the maximal sensitivity of the standard troponin assay is not achieved until 6 or more hours after the initiation of myocardial necrosis, which indicates its insufficient sensitivity for early detection of ACS. Recently, newer generations of highly-sensitive troponin assays are being developed to overcome that limitation.7 However, the newer assays demonstrate low-level cTn positively in apparently healthy people or in patients who do not have a final diagnosis of ACS. Taken together, these results highlight the importance of developing a complimentary biomarker specifically targeting early-stage ACS.
影响因子：
4.8
作者：
Inokubo, Y;Hanada, H;Okumura, K
通讯作者：
Okumura, K