高敏肌钙蛋白升高的临床意义

The clinical implications of elevated high-sensitive cardiac troponin

2009年“高敏感肌钙蛋白”检测试剂投入国内临床应用,2012年国际上又有几种高敏感试剂陆续投入临床应用,且正在进行我国食品药物管理局的报批.高敏肌钙蛋白由于检测敏感性的提高,使得对急性冠脉综合征诊断时间窗提前2～3 h,同时使对心肌损伤的检测范围与前一代试剂相比有了极大的扩展.正是由于涉及范围的扩大给临床带来许多“困惑”.在用的还没“消化”,又有新的即将进来,我们准备好了吗？我们能否像美国那样在食品和药物管理局正式批准前,检验与临床加强学习,加强沟通与交流,形成共识.

The new generation ＂high-sensitivity cardiac troponin＂ assays have been used in clinic for nearly 5 years in China. In 2012, several new high-sensitivity assays have been approved to be used in clinic in other countries, and they are under inspection of Chinese Food and Drug Ddministration. Because the new generation assays＇ sensitivity is improved, acute coronary syndrome could have been diagnosed 2-3 hours earlier, and small cardiac injuries that could not be detected by previous assays are detectable now. But its advantages also bring challenges to doctors. Many doctors can＇t even use previous assays well. The clinical doctors and laloiatory stuffs need to comunicate and reach a consensus just like American doctors do before American food and drug administration approve it.