Department of Internal Medicine, New York Medical College - Metropolitan Hospital Center, New York, NY 10029, United States of America.
Department of Internal Medicine, New York Medical College - Metropolitan Hospital Center, New York, NY 10029, United States of America.
Am J Emerg Med. 2021 Mar;41:14-15. doi: 10.1016/j.ajem.2020.12.051. Epub 2020 Dec 23.
Chest pain is one of the most common reasons for emergency department visits worldwide, and troponins play a central role in diagnosing acute coronary syndrome (ACS) in these patients. Hence, the tests for these molecules are imperative in triage for ACS. Presently, multiple high-sensitivity troponin tests are available, including those for troponin T and I. However, in the presence of physiological and pathological alterations such as chronic kidney disease (CKD) and muscle dysfunction, these tests lose their sensitivity and specificity, especially if not interpreted in the right clinical background. Further, no guidelines exist for interpreting the results in patients with CKD. We identified studies that compared the relative efficacy, sensitivity, and specificity of tests for troponin T and I in patients with CKD to understand the practical problems in the clinical interpretation of these results in the specific setting of CKD and highlight the measures to be taken into consideration.
胸痛是全球范围内急诊科就诊的最常见原因之一，而肌钙蛋白在这些患者中诊断急性冠状动脉综合征（ACS）中起着核心作用。因此，这些分子的检测对于 ACS 的分诊至关重要。目前，有多种高敏肌钙蛋白检测方法，包括肌钙蛋白 T 和 I。然而，在存在生理和病理改变的情况下，如慢性肾脏病（CKD）和肌肉功能障碍，这些检测的敏感性和特异性会降低，尤其是如果不在正确的临床背景下进行解释。此外，对于 CKD 患者，尚无解释这些检测结果的指南。我们确定了一些比较肌钙蛋白 T 和 I 检测在 CKD 患者中的相对疗效、敏感性和特异性的研究，以了解在 CKD 这一特定环境下对这些结果进行临床解释时所面临的实际问题，并强调需要考虑的措施。
