McLean Anthony S, Huang Stephen J, Salter Mark
Department of Intensive Care Medicine, Nepean Hospital, University of Sydney, Sydney, NSW 2750, Australia.
Crit Care. 2008;12(3):215. doi: 10.1186/cc6880. Epub 2008 Jun 2.
The use of cardiac biomarkers in the intensive care setting is gaining increasing popularity. There are several reasons for this increase: there is now the facility for point-of-care biomarker measurement providing a rapid diagnosis; biomarkers can be used as prognostic tools; biomarkers can be used to guide therapy; and, compared with other methods such as echocardiography, the assays are easier and much more affordable. Two important characteristics of the ideal biomarker are disease specificity and a linear relationship between the serum concentration and disease severity. These characteristics are not present, however, in the majority of biomarkers for cardiac dysfunction currently available. Those clinically useful cardiac biomarkers, which naturally received the most attention, such as troponins and B-type natriuretic peptide, are not as specific as was originally thought. In the intensive care setting, it is important for the user to understand the degree of specificity of these biomarkers and that the interpretation of the results should always be guided by other clinical information. The present review summarizes the available biomarkers for different cardiac conditions. Potential biomarkers under evaluation are also briefly discussed.
心脏生物标志物在重症监护环境中的应用越来越普遍。这种增加有几个原因：现在有了即时检测生物标志物的设备，可实现快速诊断；生物标志物可用作预后工具；生物标志物可用于指导治疗；而且，与超声心动图等其他方法相比，检测更容易且成本更低。理想生物标志物的两个重要特征是疾病特异性以及血清浓度与疾病严重程度之间的线性关系。然而，目前大多数用于心脏功能障碍的生物标志物并不具备这些特征。那些临床上有用的心脏生物标志物，自然受到了最多关注，如肌钙蛋白和B型利钠肽，其特异性并不像最初认为的那样高。在重症监护环境中，使用者了解这些生物标志物的特异性程度很重要，并且结果的解释应始终以其他临床信息为指导。本综述总结了针对不同心脏疾病可用的生物标志物。还简要讨论了正在评估的潜在生物标志物。
