Tsang Wing Man, Owen Avril M, Collinson Paul O, Barth Julian H
Department of Clinical Biochemistry, Royal Hospital Haslar, Gosport, UK.
Ann Clin Biochem. 2003 Mar;40(Pt 2):138-42. doi: 10.1258/000456303763046058.
Troponin measurements are now central to the diagnosis of acute coronary syndromes and for the stratification of the severity of cardiac disease. Some laboratories have quickly adopted the new testing strategies, which include troponin measurement for the diagnosis of acute myocardial infarction, while others are still developing appropriate protocols for cardiac testing that they can support financially. However, it is not known how widespread is the adoption of these new strategies across the UK.
The National Audit Committee of the Association of Clinical Biochemists commissioned two surveys in 1999 and 2001 to assess the status of cardiac markers currently being offered by laboratories in the UK and how this service might develop in the future.
The results show that many laboratories are continuously adapting and improving their cardiac marker testing in line with current recommendations for acute myocardial infarction. Although most laboratories are confident in the use of troponin measurement in the diagnosis of myocardial infarction, they are less confident in the use of biochemical markers in assessing prognostic outcome in the other cardiac conditions.
Finance, staffing and equipment constraints may offer significant impediments to troponin testing with a 1-h turnaround time.
肌钙蛋白检测现已成为急性冠脉综合征诊断及心脏病严重程度分层的核心。一些实验室已迅速采用新的检测策略，其中包括用肌钙蛋白检测来诊断急性心肌梗死，而其他一些实验室仍在制定其能够在经济上支持的心脏检测的合适方案。然而，在英国这些新策略的采用有多广泛尚不清楚。
临床生物化学家协会国家审计委员会在1999年和2001年进行了两项调查，以评估英国各实验室目前提供的心脏标志物的状况以及这项服务未来可能如何发展。
结果显示，许多实验室正在根据当前关于急性心肌梗死的建议不断调整和改进其心脏标志物检测。尽管大多数实验室对使用肌钙蛋白检测诊断心肌梗死有信心，但他们对在评估其他心脏疾病的预后结果时使用生化标志物信心不足。
资金、人员配备和设备限制可能对周转时间为1小时的肌钙蛋白检测构成重大障碍。
