Sensitivity and specificity of triphenyl tetrazolium chloride in the gross diagnosis of acute myocardial infarcts.
Sensitivity and specificity of triphenyl tetrazolium chloride in the gross diagnosis of acute myocardial infarcts.
复制标题
氯化三苯基四唑在急性心肌梗死肉眼诊断中的敏感性和特异性。
DOI：
--
复制
发表时间：
1997
影响因子：
4.6
通讯作者：
P. Boor
中科院分区：
文献类型：
--
作者：
P. Adegboyega;A. Adesokan;A. Haque;P. Boor
目标
心肌梗塞是美国猝死的最常见原因。然而，在尸检时识别早期心肌梗塞通常很困难，因为梗塞的明确总体变化在心肌缺血性损伤后 24 至 48 小时内不会变得明显。主要通过动物研究表明，使用硝基蓝四唑和氯化 2,3,5 三苯基四唑 (TTC) 等染料来识别脱氢酶缺陷型梗塞心肌，对于此类病例的宏观诊断非常有帮助。然而，此类动物研究不能直接外推到人类尸检研究，因为自溶可能会使死后心肌酶促变化的组织化学评估无效。本研究旨在评估 TTC 在人群急性心肌梗死粗略诊断中的敏感性和特异性。
设计
TTC 染色反应与 638 例连续成人尸检心脏的组织学结果相关。
结果
在 TTC 检查的 638 颗心脏中，174 颗心脏急性梗塞染色呈阳性；组织学证实 140 颗心脏存在心肌梗塞。组织学检查显示，其余 464 例 TTC 染色呈阴性的病例中，有 41 例存在急性梗塞。使用 TTC 对人群急性心肌梗塞进行肉眼诊断，诊断灵敏度为 77.4%，特异性为 92.6%。阳性检测的预测值为80.5%，阴性检测的预测值为91.2%。
结论
TTC测试的总体诊断效率（即正确识别的患者数量）为88%。这些结果表明，TTC 测试是尸检时人类心脏检查中可靠、灵敏且特异的辅助手段。
OBJECTIVE
Myocardial infarction is the most common cause of sudden death in the United States. However, the identification of early myocardial infarcts at necropsy is frequently difficult, since unequivocal gross changes of infarcts do not become apparent for 24 to 48 hours following myocardial ischemic injury. The use of dyes, such as nitro-blue tetrazolium and 2,3,5 triphenyl tetrazolium chloride (TTC), that identify the dehydrogenase-deficient infarcted myocardium has been shown, largely by animal studies, to be very helpful in the macroscopic diagnosis of such cases. Such animal studies could not be directly extrapolated to human autopsy studies, however, because of the assumption that autolysis may invalidate the histochemical assessment of myocardial enzymatic changes after death. This study was carried out to evaluate the sensitivity and specificity of TTC in the gross diagnosis of acute myocardial infarction in the human population.
DESIGN
The TTC stain reactions were correlated with histologic findings in the hearts of 638 consecutive adult autopsies.
RESULTS
Of the 638 hearts examined by TTC, 174 hearts stained positive for acute infarction; histology confirmed myocardial infarction in 140 hearts. Histologic examination revealed acute infarcts in 41 of the remaining 464 cases that had stained negatively with TTC. The use of TTC in the macroscopic diagnosis of acute myocardial infarcts in the human population was found to have a diagnostic sensitivity of 77.4% and a specificity of 92.6%. The predictive value of a positive test was 80.5%, and that of a negative test was 91.2%.
CONCLUSIONS
The overall diagnostic efficiency of the TTC test (ie, number of patients correctly identified) was 88%. These results show that the TTC test is a reliable, sensitive, and specific adjunct in the examination of the human heart at necropsy.