Chapelle J P
Université de Liège, Service de Chimie médicale.
Rev Med Liege. 1998 Oct;53(10):619-24.
The troponin (Tn) complex consists of three protein subunits referred to as TnT, TnI and TnC. Myocardium contains TnI and TnT isoforms which are not present in skeletal muscles and which can be separated from the muscular isoforms by immunological techniques. Using commercially available immunoassays, clinical laboratories are able to determine cardiac TnT and TnI (cTnT and cTnI) as quickly and reliably as classical cardiac markers. After acute myocardial infarction, cTnT and cTnI concentrations start to increase in serum in a rather similar way than CK-MB, but return to normal after longer periods of time (approximately one week). Because of their excellent cardiac specificity, Tn subunits appear ideally suited for the differential diagnosis of myocardial and muscular damage, for example in non cardiac surgery patients, in patients with muscular trauma or with chronic muscular diseases, or after intensive physical exercise. cTnT and cTnI may also be used for detecting evidence of minor myocardial damage, and therefore may find new applications in the management of patients with unstable angina.
肌钙蛋白(Tn)复合体由三种蛋白质亚基组成,分别称为肌钙蛋白T(TnT)、肌钙蛋白I(TnI)和肌钙蛋白C(TnC)。心肌含有骨骼肌中不存在的TnI和TnT同工型,可通过免疫技术将其与肌肉同工型分离。使用市售的免疫测定法,临床实验室能够像检测传统心脏标志物一样快速、可靠地测定心脏肌钙蛋白T(cTnT)和心脏肌钙蛋白I(cTnI)。急性心肌梗死后,血清中cTnT和cTnI浓度开始升高,其方式与肌酸激酶同工酶MB(CK-MB)相当相似,但较长时间(约一周)后恢复正常。由于其出色的心脏特异性,Tn亚基似乎非常适合用于心肌和肌肉损伤的鉴别诊断,例如在非心脏手术患者、肌肉创伤患者或慢性肌肉疾病患者中,或在剧烈体育锻炼后。cTnT和cTnI也可用于检测轻微心肌损伤的证据,因此可能在不稳定型心绞痛患者的管理中找到新的应用。