Penttilä K, Penttilä I, Bonnell R, Kerth P, Koukkunen H, Rantanen T, Svanas G
Department of Clinical Chemistry, Kuopio University Hospital, Finland.
Eur J Clin Chem Clin Biochem. 1997 Oct;35(10):767-74. doi: 10.1515/cclm.1997.35.10.767.
We describe an improved procedure using a standard microplate immunoassay reader to measure the concentration of troponin T in human serum. We also describe an immunoassay for troponin I in serum. Only 160 microliters of serum are needed for a single analysis of each troponin. For comparison, creatine kinase MB mass analysis in serum was performed with a commercial luminometric method. From 95 apparently healthy people the following values were obtained: creatine kinase MB mass 2.6 +/- 1.2 micrograms/l, troponin T 0.027 +/- 0.025 microgram/l and troponin I 0.03 +/- 0.031 microgram/l. We compared the results of troponin T and troponin I methods with each other, as well as with those of creatine kinase MB mass measured in 48 patients with verified acute myocardial infarction and in 60 control patients with non-cardiac chest pain. The correlation between troponin T and troponin I values was 0.91 for the total material and 0.94 for 48 patients with acute myocardial infarction. Troponin I showed better earlier sensitivity than troponin T (p = 0.043). In nine patients in the control group, creatine kinase MB mass exceeded the reference limit of 5.0 micrograms/l, while in two patients the cut-off limit of 10.0 micrograms/l was also surpassed, pointing to non-specificity. In the group of infarct patients, the highest serum creatinine value was 193 mumol/l, whereas in the control group it was 406 mumol/l. The sera of patients with impaired renal function without any cardiac failure showed no increase in troponin T and troponin I values. In conclusion, serum creatine kinase MB mass and troponin I seem to confirm an acute myocardial infarction more rapidly than does troponin T; troponin I has the highest cardiac specificity.
我们描述了一种使用标准微孔板免疫测定仪测量人血清中肌钙蛋白T浓度的改进方法。我们还描述了一种血清中肌钙蛋白I的免疫测定方法。每次分析每种肌钙蛋白仅需160微升血清。作为对比，采用商业发光法对血清中的肌酸激酶MB质量进行分析。从95名看似健康的人身上获得了以下数值：肌酸激酶MB质量为2.6±1.2微克/升，肌钙蛋白T为0.027±0.025微克/升，肌钙蛋白I为0.03±0.031微克/升。我们将肌钙蛋白T和肌钙蛋白I方法的结果相互比较，同时也与48例经证实的急性心肌梗死患者和60例非心源性胸痛对照患者中测量的肌酸激酶MB质量结果进行比较。肌钙蛋白T和肌钙蛋白I值之间的相关性，对于全部样本为0.91，对于48例急性心肌梗死患者为0.94。肌钙蛋白I比肌钙蛋白T显示出更好的早期敏感性（p = 0.043）。在对照组的9名患者中，肌酸激酶MB质量超过了5.0微克/升的参考限值，而在2名患者中还超过了10.0微克/升的临界值，这表明存在非特异性。在梗死患者组中，血清肌酐的最高值为193微摩尔/升，而在对照组中为406微摩尔/升。肾功能受损且无任何心力衰竭的患者血清中，肌钙蛋白T和肌钙蛋白I值没有升高。总之，血清肌酸激酶MB质量和肌钙蛋白I似乎比肌钙蛋白T能更快地证实急性心肌梗死；肌钙蛋白I具有最高的心脏特异性。
