心肌标志物的分类和临床应用（Classification and clinical application of cardiac markers）.docVIP

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心肌标志物的分类和临床应用（Classification and clinical application of cardiac markers）.doc

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心肌标志物的分类和临床应用（Classification and clinical application of cardiac markers） 1. types of cardiac markers The major markers of myocardial injury include troponin T (troponinT), troponin I (troponinI), creatine kinase isoenzyme mass (CK-MBmass) and myoglobin (myoglobin). Troponin is composed of 3 subunits, each of them has independent structure and different role in the regulation of cardiac troponin regulation mediated by interactions between actin and myosin in calcium participation, so as to maintain the relaxation and contraction of myocardium. When the myocardial cell membrane is intact, the cardiac troponin does not release the membrane into the bloodstream, and the troponin is released into the bloodstream only when the membrane is destroyed. The concentration of troponin in the blood circulation is proportional to the program of myocardial damage, and has a half-life of up to 15d. It is the best index for the retrospective examination. CK energy metabolism enzyme, an important intracellular distribution of a wide range of muscle cells to the most, is composed of two subunits of two dimers; ectoplasm CK-MB mainly in myocardial cells, has been a clinical diagnosis of myocardial injury and myocardial enzyme spectrum in the most specific enzyme, but many interference factors for immune determination of enzyme activity inhibition method for a long time, the sensitivity and specificity of detection were greatly affected, it is recommended the quality of CK-MB was determined by chemiluminescence method by the American Heart Association and the European Society of cardiology can not be affected by the concentration of enzyme activity, direct detection of CK-MB molecules, can be more sensitive and specific for clinical help. Myoglobin is mainly found in striated muscle cells (cardiomyocytes and skeletal muscle) and plays an important role in the oxidation of cell membranes. Because of its small molecules (molecular weight 17000 ~ 18000), when the injury of myocardial cell