評估Troponin I, CK-MB mass 及Myoglobin 於急性冠心症診斷效率之研究

Efficacy Evaluation of Troponin I, CK-MB Mass and Myoglobin in Diagnosis of Acute Coronary Syndrome in Emergency

每年有大量的病人在急診死於急性冠心症，病患可以根據症狀的危險因子和心電圖結果作分類，但心臟生物標記也是診斷和預後重要的指標。本文，我們評估針對急診室胸痛的患者中，Myoglobin, CK-MB mass和Troponin I在急性冠心症的診斷效率，並評估報告時效。研究以螢光免疫分析法測量Myoglobin、CK-MB mass和Troponin I的濃度。結果顯示，單獨檢驗Troponin I具有最佳的特異性與陽性預測值（0.92, 0.5）。同時檢測Myoglobin，CKMB與Troponin I則具有最佳的敏感性與陰性預測值（0.83, 0.93）。平均報告時間為32.5分鐘。結論：使用套組式心臟生物標誌同時檢測Myoglobin、CKMB與Troponin I，搭配定點快速檢驗系統，可以幫助臨床快速且正確的排除疑似急性冠心症的病患。

Many people died from acute coronary syndrome in emergency every year. The diagnosis and prognosis in attacked patients varied, including clinical symptoms, the electrocardiography and measurement of cardiac biomarkers. The purpose of this study was to evaluate the efficacy of using Troponin I, Myoglobin and CK-MB mass as biomarkers for diagnosing patients with chest pain in the emergency room as acute coronary heart disease. Thef luorescence immunoassay was performed to determine the concentration of Troponin I, Myoglobin and CK-MB mass. Results showed signle Troponin I test had the highest specificity and positive predictive value (0.92, 0.5). In contrast, simultaneous determination of Myoglobin, CK-MB and Troponin I had the highest sensitivity and negative predictive value (0.83, 0.93). The average of time-to-report was 32.5 minutes. Results suggest that the Pack-cardiac biomarkers simultaneously detecting Myoglobin, CKMB and Troponin I, with a fixed-point fast inspection system can be used in clinical setting to rapidly diagnose patients of acute coronary heart disease.