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[高敏肌钙蛋白T检测的性能及临床应用]

[Performance and clinical utility of a high-sensitivity troponin T assay].

作者信息

Okura Hiroe, Suzuki Reiko, Sugibayashi Sachiyo, Yoshika Masamichi, Takahashi Hakuo

机构信息

Department of Clinical Laboratory, Kansai Medical University Hirakata Hospital, Hirakata 573-1191, Japan.

出版信息

Rinsho Byori. 2012 May;60(5):407-13.

PMID:22774568
Abstract

In the present study, we evaluated the performance and clinical utility of a high-sensitivity troponin T (hs-cTnT) assay. The within- and between-assay variations (coefficients of variation: CV) in the low and high concentrations of troponin T in serum samples were 0.84% to 3.34%, respectively. Analysis of interferents showed that only hemoglobin negatively influenced the assay results. Blank assay was < 0.001 ng/mL, and a limit of quantification (10% CV) was found at 0.005 ng/mL. The correlation coefficient (r) between hs-cTnT and the conventional assay was 0.997 (p < 0.000). The high-sensitivity assay system could detect cTnT in 88% of samples in which the conventional assay could not detect any immunoreactivity. The 99th percentile in healthy subjects, determined using 559 samples from medical checkups, was 0.011 ng/mL. There was a gender difference (hs-cTnT levels were higher in men than in women), and hs-cTnT levels increased with age. Because hs-cTnT level exceeded 0.011 ng/mL approximately 2 hours after the onset of chest pain in patients with acute myocardial infarction, hs-cTnT can serve as a biomarker for early detection of myocardial infarction. There was a positive correlation (r = 0.491, p < 0.001) between hs-cTnT and NT-proBNP, and hs-cTnT levels increased with the progression of the disease state, as assessed using New York Heart Association (NYHA) classification. These findings indicate that the hs-cTnT assay is sensitive enough to diagnose early-stage acute myocardial infarction and congestive heart failure.

摘要

在本研究中,我们评估了高敏肌钙蛋白T(hs-cTnT)检测方法的性能和临床实用性。血清样本中低浓度和高浓度肌钙蛋白T的批内和批间变异(变异系数:CV)分别为0.84%至3.34%。干扰物分析表明,只有血红蛋白对检测结果有负面影响。空白检测值<0.001 ng/mL,定量限(10% CV)为0.005 ng/mL。hs-cTnT与传统检测方法之间的相关系数(r)为0.997(p<0.000)。高敏检测系统能够在88%的传统检测方法无法检测到任何免疫反应性的样本中检测到cTnT。使用559份体检样本确定的健康受试者第99百分位数为0.011 ng/mL。存在性别差异(男性的hs-cTnT水平高于女性),且hs-cTnT水平随年龄增长而升高。由于急性心肌梗死患者胸痛发作后约2小时hs-cTnT水平超过0.011 ng/mL,因此hs-cTnT可作为心肌梗死早期检测的生物标志物。hs-cTnT与NT-proBNP之间存在正相关(r = 0.491,p<0.001),并且根据纽约心脏协会(NYHA)分级评估,hs-cTnT水平随疾病状态的进展而升高。这些发现表明,hs-cTnT检测方法足够灵敏,能够诊断早期急性心肌梗死和充血性心力衰竭。

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