Analyses of N-Terminal pro-brain natriuretic peptide, cardiac troponin T, and creatine kinase MB in pericardial fluid in sudden cardiac death caused by ischemic heart disease
Analyses of N-Terminal pro-brain natriuretic peptide, cardiac troponin T, and creatine kinase MB in pericardial fluid in sudden cardiac death caused by ischemic heart disease
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缺血性心脏病引起的心源性猝死心包液中 N 端脑钠肽前体、心肌肌钙蛋白 T 和肌酸激酶 MB 的分析
DOI：
10.4103/jfsm.jfsm_124_22
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发表时间：
2022
影响因子：
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通讯作者：
Rui Zhao
中科院分区：
文献类型：
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作者：
Z. Cao;Tianqi Wang;Shao;Zihan Liao;B. Zhu;Rui Zhao
背景：在以往的法医学研究中，N 端脑钠肽前体 (NT-proBNP)、心肌肌钙蛋白 T (cTnT) 和肌酸激酶 MB (CK-MB) 的生化分析对于心源性猝死 (SCD) 的辅助诊断具有重要价值。目的和目的：本研究旨在评估心包液中 NT-proBNP、cTnT 和 CK-MB 联合分析对缺血性心脏病引起的 SCD 法医诊断的诊断效率。材料与方法：采用电化学发光法检测132例法医尸检心包液中NT-proBNP、cTnT、CK-MB水平。结果：SCD 病例中 NT-proBNP、cTnT 和 CK-MB 水平显着升高（P < 0.05）。接受者操作特征（ROC）分析显示NT-proBNP、cTnT和CK-MB对SCD的诊断具有诊断价值：NT-proBNP，临界值为2236 pg/ml； cTnT，截止值为 199.51 ng/ml； CK-MB：截止值为2742.5 ng/ml，这三种生物标志物的联合分析比单独的单个生物标志物具有更好的诊断效率。此外，将SCD的病因细分为急性缺血性心脏病、急性心肌梗死（AMI）和复发性心肌梗死亚组进行进一步分析，发现cTnT/CK-MB比值可用于区分AMI，ROC分析估计的临界值为0.1085。结论：这些观察结果表明，死后心包液中 NT-proBNP、cTnT 和 CK-MB 的生化分析可能有助于法医学实践中 SCD 的诊断，并且多种生物标志物的联合分析比单独使用单个生物标志物具有更好的诊断效率。在死后NT-proBNP、cTnT和CK-MB生化分析的基础上，结合cTnT/CK-MB比值可用于区分AMI。
Background: Biochemical analyses of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and creatine kinase MB (CK-MB) have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death (SCD) in previous forensic studies. Aims and Objectives: The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT-proBNP, cTnT and CK-MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease. Materials and Methods: Levels of NT-proBNP, cTnT, and CK-MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method. Results: NT-proBNP, cTnT, and CK-MB levels were significantly elevated in SCD cases (P < 0.05). Receiver-operating characteristics (ROC) analysis showed that NT-proBNP, cTnT, and CK-MB have diagnostic value for the diagnosis of SCD: NT-proBNP, cutoff value of 2236 pg/ml; cTnT, cutoff value of 199.51 ng/ml; CK-MB: cutoff value of 2742.5 ng/ml, and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone. Moreover, the causes of SCD were sub-divided into acute ischemic heart disease, acute myocardial infarction (AMI), and recurrent myocardial infarction subgroups for further analysis, which revealed that the ratio of cTnT/CK-MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis. Conclusion: These observations suggested that the postmortem biochemical analyses of NT-proBNP, cTnT, and CK-MB in the pericardial fluid may assist to diagnose SCD in forensic practice, and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone. On the basis of the postmortem biochemical analyses of NT-proBNP, cTnT and CK-MB, combining the ratio of cTnT/CK-MB could be used to distinguish AMI.