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CLIN CHEM：如何定量释放的心肌坏死标志物？

2017-06-10 MedSci MedSci原创

心肌坏死标志物
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当心脏坏死的生物标志物超过第99百分位数时即诊断为心肌梗死。尽管指南用更低的的浓度来进行早期排除。最近的指南提出排除和纳入的临界值应该比第99个百分位数功能更为宽泛，并利用第一次和第二次抽血之间的浓度微小变化（δ值）来识别急性心肌损伤。近日，国际杂志 《CLIN CHEM》上在线发表一项关于如何定量释放的心肌坏死标志物的研究。

当心脏坏死的生物标志物超过第99百分位数时即诊断为心肌梗死。尽管指南用更低的的浓度来进行早期排除。最近的指南提出排除和纳入的临界值应该比第99个百分位数功能更为宽泛，并利用第一次和第二次抽血之间的浓度微小变化（δ值）来识别急性心肌损伤。近日，国际杂志 《CLIN CHEM》上在线发表一项关于如何定量释放的心肌坏死标志物的研究。

研究人员将个体大鼠心肌细胞，大鼠心肌层细胞，羊心肌层细胞或人心肌层细胞注入400μL等份的人血清。对摄入羊心肌的志愿者抽取血液。采用高灵敏度测定用于测量心肌钙蛋白T（cTnT的;罗氏，Elecsys测定），肌钙蛋白I（雅培，Architect），和心脏肌球蛋白结合蛋白C（CMYC;密理博，Erenna ®）。

cMyC检测只能检测到人类蛋白质。对于每个大鼠心肌细胞加入400μL人血清，cTnT和cTnI分别增加了19.0 ng / L（95％CI，16.8-21.2）和18.9 ng / L（95％CI，14.7-23.1）。在相同条件下，cTnT，cTnI和cMyC分别增加3.9 ng / L（95％CI，3.6-4.3），4.3 ng / L（95％CI，3.8-4.7）和41.0 ng / L（95％CI，38.0 -44.0）每μg人心肌。摄入足够的羊心肌将cTnT和cTnI增加到其定量下限的约1×10 8倍后，cTnI或cTnT浓度未发生变化。

研究认为基于cTn和cMyC释放效率，循环物质和分布体积的实际假设，40mg心肌的坏死超过了第99百分位浓度。该体积太小，无法通过非侵入性成像所检测到。

原始出处：

Jack Marjot, Thomas E. Kaier, Eva D. Martin,et al. Quantifying the Release of Biomarkers of Myocardial Necrosis from Cardiac Myocytes and Intact Myocardium.May.2017

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    2018-05-17 hukaixun

    #标志物#

    0

  2. 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    2017-06-12 ylzr123

    认真学习，把间接经验应用到临床实践中去，然后再总结出新思路。给点赞啦

    0

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content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-12 millore

    #坏死#

    0

  4. 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content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1821efe7b1m

    学习了

    0

  5. 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time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

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content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

  7. 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content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

  8. 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time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:27 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209210, encodeId=7c14209210f8, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:21 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209209, encodeId=7ae620920976, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1841026, encodeId=c90b184102670, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Thu May 17 13:47:00 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209752, encodeId=c7c0209e52a2, content=认真学习，把间接经验应用到临床实践中去，然后再总结出新思路。给点赞啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Jun 12 08:47:33 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362833, encodeId=a5201362833b0, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Mon Jun 12 07:47:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209448, encodeId=1f7f20944891, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/04/441763570d47c65a6f08b67489e7a96c.jpg, createdBy=13be2070061, createdName=1821efe7b1m, createdTime=Sun Jun 11 15:48:22 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209212, encodeId=d2bb2092122f, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:34 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209211, encodeId=0fb120921106, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:27 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209210, encodeId=7c14209210f8, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:21 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209209, encodeId=7ae620920976, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:14 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209208, encodeId=1d9320920854, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209207, encodeId=b0cd20920ef2, content=值得学习分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrs2asVmGicNahCpBSxNUbSuA4vpeiazhWPdV79iaSIJsvMiaGECEouckrnOYc6073M9RbpNPL6qU9SdfB5BsicIqON4X/0, createdBy=f47f2017208, createdName=1e20390em99(暂无匿称), createdTime=Sun Jun 11 07:10:00 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 1e20390em99(暂无匿称)

    值得学习分享

    0

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