Näslund Ulf
Hjärtcentrum, Norrlands Universitetssjukhus, Umeå.
Lakartidningen. 2002 Jun 20;99(25):2834-9.
The American College of Cardiology and the European Society of Cardiology have recently published new guidelines on the diagnosis of acute myocardial infarction. These guidelines emphasize the importance of biochemical markers for diagnosis, and define standards for the quality of laboratory methods and decision limits. Each laboratory method in clinical routine use should be described in a peer-reviewed medical publication, the coefficient of variation should be < 10% in a normal reference population, and the decision level for myocardial injury should be set at the 99th percentile. Blood sampling should be individualized with regard to the onset of symptoms. Analysis of a troponin should be the standard method. If these guidelines become generally accepted the diagnostic accuracy of the methods will be improved and important prognostic information will be gained.
美国心脏病学会和欧洲心脏病学会最近发布了关于急性心肌梗死诊断的新指南。这些指南强调了生化标志物在诊断中的重要性，并定义了实验室方法质量和决策限的标准。临床常规使用的每种实验室方法都应在同行评审的医学出版物中进行描述，在正常参考人群中变异系数应<10%，心肌损伤的决策水平应设定在第99百分位数。血液采样应根据症状发作情况个体化。肌钙蛋白分析应作为标准方法。如果这些指南被普遍接受，方法的诊断准确性将得到提高，并将获得重要的预后信息。
