Cardiac Troponin I

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兆牡戌雷
9 years ago
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1 website:wwwsupermtcomtw 1

2 ? (AMI) (cardiac angina) [ ][WHO1971] ECG ST Q [ CK MB CK-MB LD-1] [Ellis,1991] ( ) (CK-MB ) CK-MB (ECG) % (silent infarction) (silent ischemia) 20%30% 4% Cardiac STAus TM (CK-MBMyoglobulinTroponin I) ( ACS Troponin I website:wwwsupermtcomtw 2

3 Cardiac Troponin I Cardiac Troponin I (AMI) CK-MB CK-MB CK-MB CK-MB 110 [ (MMD)] (CABG) website:wwwsupermtcomtw 3

4 [Opie 1991, Braunwald 1989, Erbel et al 1993, Nellessen et al 1993a, Nellessen et al 1993b] 21 :,, NADH 2 22 website:wwwsupermtcomtw 4

5 21 MVO 2 website:wwwsupermtcomtw 5

6 Salvage Thrombolysis AMI NECROSIS Ischemia Minutes Hours True infarct No collaterals High Mvo 2 Collaterals low Mvo (<90%) 2 (36-97%) 3 (15-45%) 1 (15-30%) 23 urokinase (streptokinase), tpa, rtpa or rpa website:wwwsupermtcomtw 6

Mvo 2 22 1 (<90%) 2 (36-97%) 3 (15-45%) 1 (15-30%) 23

7 1 Angina pectois 2 Pulmonary embolism 3 Dry pleurisy 4 Pericarditis 5 Diaphragmatic hernia 6 ( ) Dissecting aneurysm 7 Acute abdomen 8 Aerothorax ( ) , CK,SGOT, LD-1,CK-MB,a-HBDH ( ) + website:wwwsupermtcomtw 7

aneurysm 7 Acute abdomen 8 Aerothorax ( ) + + + - + + + + +,

8 31 31 ( 85%) ( 6 ) website:wwwsupermtcomtw 8

9 Troponin I (Troponin T) 32 website:wwwsupermtcomtw 9

10 - Troponin I 41 myosin actin tropomyosin troponin Katus et al 1992a Troponin I (TnI) (265kD) actomyosin ATPase Troponin C Troponin T (TnT) 39kD (kilodalton) Troponin C (TnC) (18kD) 41 Troponin T troponin complex troponyosin TnI- website:wwwsupermtcomtw 10

Troponin T (TnT) 39kD (kilodalton) Troponin C (TnC) (18kD) 41

11 Troponin C Troponin TnI TnC ATP ATP TnC TnC TnI ATPase [Bodor 1991, Katus et al 1992, Rhoades et al 1992, Paul et al 1993a/b] I I C website:wwwsupermtcomtw 11

12 Troponin I Troponin I (IMI) IMI AMI MMD Post-AMI acute Ischemic Myocardial Injury Acute Myocardial Infarction Minor Myocardial Damage Recent AMI TnI CK-MB mass 600 AMI TnI CK-MB mass (CK CK cat) (TnI CK-MB mass) CK-MB mass TnI TnI TnI TnI TnI CK-MB mass AMI 10 TnI [ ] website:wwwsupermtcomtw 12

Recent AMI TnI CK-MB mass 600 AMI TnI CK-MB mass (CK CK cat) (TnI CK-MB

13 (CCU) TnI (CCU) S-TnI CCU 010 ug/l IMI 010 ug/l IMI S-CK-MB(mass) 10 ug/l MMD,POST-AMI S-CK-MB(mass) 10 ug/l AMI TnI < 01 ug/l AMI TnI > 01 ug/l IMICK-BM mass < 10 ug/l AMI TnI CK-MB mass MMD Post-AMI TnI > 01 ug/l CK-MB mass > 10 ug/l AMI website:wwwsupermtcomtw 13

TnI > 01 ug/l IMICK-BM mass < 10 ug/l AMI TnI CK-MB mass MMD

14 Troponin I, AACC American Association of Clinical Chemistry ACS Acute coronary syndrome -HDBH -Hydroxy Butyrate Dehydrogenase AMI Acute myocardial infarction, ATP Adenosintriphosphate C 10 H 16 N 5 O 12 P 3 SMC Superior Medicare Co, BNA Behring Nephelometric analyzer CAD Coronary artery disease Cat No Catalogue nomenclature CABG Coronary Artery Bypass Grafting, CCU Coronary care unit CHF Congestive heart failure CK Creatine kinase CK-MB Creatine kinase isoform MB 15%-30%, MM 70%-85% CV Coeffizient of Variation ctni Cardiac troponin I I ctnt Cardiac troponin T T website:wwwsupermtcomtw 14

Cat No Catalogue nomenclature CABG Coronary Artery Bypass Grafting, CCU Coronary care unit CHF Congestive heart failure CK Creatine kinase CK-MB

15 ECG Electrocardiography ER Emergency Room ECLIA Electro-Chemiluminesce-Immuno-Assay ELISA Enzyme-linked Immunosorbent Assay GUSTO Global Use of Strategies To Open Coronary Arteries h (hrs) Hour(s) IFCC International Federation of Clinical Chemistry IHD Ischemic heart disease, IMI Ischemic Myocardial Injury IU International Units / mol/i KDa Kilo Dalton - ( ) LDH / LD Lactate dehydrogenase MAB Monoclonal Antibody,, Min Minutes MI Myocardial infarction MLC Myosin Light Chain MMD Minor myocardial damage MVO 2 Myocardial oxygen uptake MW Molecular weight NAC N-Actetyl-Cystein N- - NADH 2 Nicotinamide Adenine Dinucleotide C 21 H 27 O 14 P 2, website:wwwsupermtcomtw 15

Units / mol/i KDa Kilo Dalton - ( ) LDH / LD Lactate dehydrogenase MAB Monoclonal Antibody,, Min Minutes MI Myocardial infarction MLC Myosin Light Chain MMD Minor

16 PTCA ROM RT-PCR STAT stnt t TIMI tpa rpa rtpa Tn TnC TnI TnT UAP Percutaneous transluminal coronary angioplasty Gruentzig,,X,, 1977 Read only memory ( ) Reverse transcriptase polymerse chain reaction - Short turn around time Skeletal troponin T T time Thrombolysis in myocardial infarction tissue Plasminogen Activator recombination Plasminogen Activator tissue recombination Plasminogen Activator Troponin, 365x10-9 m Troponin C (C Contractile) Troponin I (I Inhibitory) Troponin T (T Tropomyosin) Unstable Angina Pectoris,,,, ( ),,,,,,, website:wwwsupermtcomtw 16

infarction tissue Plasminogen Activator recombination Plasminogen Activator tissue recombination Plasminogen Activator Troponin, 365x10-9 m

17 US FDA United States Food And Drug Administration UV Ultra Violet, 340 nm WHO World Health Organization XR Cross reactivity Superior Cardiac STATus website:wwwsupermtcomtw 17

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