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  • 1 Kanizsai Dorottya Kórház, Nagykanizsa, Szekeres u. 2–8., 8800
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest
  • 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest
  • 4 Kanizsai Dorottya Kórház, Nagykanizsa

Absztrakt

Bevezetés: A szív biomarkerei kiemelkedő szerepet kaptak az akut myocardialis infarctus diagnosztikájában. Célkitűzés: A szerzők automatizáltan mérhető szívbiomarkerek diagnosztikai hatékonyságát vizsgálták. Módszer: Mieloperoxidázt, nagy érzékenységű C-reaktív fehérjét, mioglobint, szívtípusú zsírsavkötő fehérjét, kreatinkinázt, kreatinkináz-MB-t, nagy érzékenységű troponin-I-t és -T-t mértek. Eredmények: Akut myocardialis infarctusban a leghatékonyabbnak (görbe alatti terület: 0,86; 95%-os megbízhatósági tartomány: 0,77–0,95; p<0,001) a nagy érzékenységű troponin-I bizonyult. A kritikus értéknél (0,35 ng/mL) az érzékenység 81%, a fajlagosság 74% volt. A nagy érzékenységű troponin-T, -I, a mellkasi fájdalom és az elektrokardiogram együttes értékelése különítette el legjobban az akut myocardialis infarctust az egyéb kórképektől (korrekt besorolás: 62,5% és 98,9%). Következtetések: Amíg nem áll rendelkezésre megfelelő érzékenységű és fajlagosságú szívbiomarker, addig nincs jobb módszer az akut myocardialis infarctus gyanúja esetén, mint 3–6 óra múlva újra elvégezni az elektrokardiogram- és biomarker-vizsgálatot. Orv. Hetil., 2015, 156(24), 964–971.

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