A MXene-functionalized paper-based electrochemical immunosensor for label-free detection of cardiac troponin I

Convenient,rapid,and accurate detection of cardiac troponin I(cTnI)is crucial in early diagnosis of acute myocardial infarction(AMI).A paper-based electrochemical immunosensor is a promising choice in this field,because of the flexibility,porosity,and cost-efficacy of the paper.However,paper is poor in electronic conductivity and surface functionality.Herein,we report a paper-based electrochemical immunosensor for the label-free detection of cTnI with the working electrode modified by MXene(Ti_(3)C_(2))nanosheets.In order to immobilize the bio-receptor(anti-cTnI)on the MXene-modified working electrode,the MXene nanosheets were functionalized by aminosilane,and the functionalized MXene was immobilized onto the surface of the working electrode through Nafion.The large surface area of the MXene nanosheets facilitates the immobilization of antibodies,and the excellent conductivity facilitates the electron transfer between the electrochemical species and the underlying electrode surface.As a result,the paper-based immunosensor could detect cTnI within a wide range of 5-100 ng/mL with a detection limit of 0.58 ng/mL.The immunosensor also shows outstanding selectivity and good repeatability.Our MXene-modified paper-based electrochemical immunosensor enables fast and sensitive detection of cTnI,which may be used in real-time and cost-efficient monitoring of AMI diseases in clinics.

Characteristics of elevated cardiac troponin I in patients with acute ischemic stroke

ObjectiveTo 学习心脏的 troponin 的预示的特征我(cTnI ) 在尖锐 ischemic stroke.MethodsWe 的举起回顾地学习了病人(n = 248 ) 与尖锐 ischemic 击，尖锐圣片断举起心肌的梗塞，和尖锐 non-ST-elevation 心肌的梗塞在 2013 年 1 月和 2015 年 10 月之间被对待。在在这三个组之中的 cTnI 层次的基线人口统计的数据和变化被比较。有尖锐 ischemic 击的病人被分到 cTnI 举起组也(cTnI > 0.034 ng/mL ) 或没有 cTnI 举起组(cTnI 0.034 ng/mL ) 。逻辑回归分析被用来识别与尖锐 ischemic 击在病人与提高的浆液 cTnI 联系的风险因素。而且，医院停留和主要心血管的结果的发生的持续时间与尖锐 ischemic 击在病人被作比较，与尖锐 ischemic 击与这或没有提高的 cTnI.ResultsIn 学习病人的人口( n = 178 )，尖锐圣片断举起心肌的梗塞( n = 35 )，并且尖锐 non-ST-elevation 心肌的梗塞( n = 35 )，有有提高的 cTnI 的尖锐 ischemic 击的病人包括了18.5%题目。有提高的 cTnI 的病人更老、更可能有高血压的历史。另外，这些病人有煽动性的标记，减少的肾的功能，增加的 D 暗淡层次，更高的 NIH 击分数，和更低的左室的喷射部分的高水平。逻辑回归分析两个都显示出那百分比嗜中性并且 NIH 击分数被提高；估计的 glomerular 过滤率和左室的喷射部分与尖锐 ischemic 击在病人被减少提高了 cTnI，并且他们在与尖锐 ischemic 击在病人检测的医院 stay.ConclusionElevated cTnI 期间有更经常的主要心血管的事件，在医院停留期间显示了差的短期的预后的更大的可能性的。

Differential IFN-Gamma (IFN-γ), Interleukin 10 (IL-10) and Cardiac Troponin I (cTnI) Responses in Natural Bovine Trypanosomosis in Nigeria

Trypanosomosis is major drawback to profitable livestock production in sub-Sahara African, including Nigeria. Knowledge of the cytokines production in the phase of natural infection may help to better diagnose, treat and prevent bovine trypanosomosis. The purpose of the this study was to determine the levels of interferon-gamma (IFN-γ), interleukin-10 (IL-10) and cardiac troponin–I (cTnI) in the sera of cattle naturally infected with T. brucei, T. congolense and T. vivax and correlate these levels with parasitaemia and PCV of the infected animals. Five milliliter of blood samples were collected via the jugular vein from 411 randomly selected cattle into EDTA and non-citrated bottle. PCV was determined manually using HCT. Trypansomes were detected and characterized by microscopy and PCR, respectively. Serum levels of IFN-γ, IL-10 and cTnI were determined using commercial ELISA kit. Data were summarized using descriptive statistic and significance of differences determined by ANOVA. Of the 62 samples positive for trypanosomes by microscopy, 50 samples were confirmed to species level by PCR. The sera levels of IFN-γ, IL-10 and cTnI of infected cattle were higher than non-infected cattle. The differences were not significant (p γ, IL-10 and cTnI in cattle with natural trypanosomosis. Further investigation is required to understand the specific effect of trypanosomes on myocardiac integrity and interaction between the two cytokines in natural trypanosomosis in cattle.

Elevated level of high-sensitivity cardiac troponin I as a predictor of adverse cardiovascular events in patients with heart failure with preserved ejection fraction

Background:The relationship between the elevation of cardiac troponin and the increase of mortality and hospitalization rate in patients with heart failure with reduced ejection fraction is clear.This study investigated the association between the extent of elevated levels of high-sensitivity cardiac troponin I(hs-cTnI)and the prognosis in heart failure with preserved ejection fraction patients.Methods:A retrospective cohort study consecutively enrolled 470 patients with heart failure with preserved ejection fraction from September 2014 to August 2017.According to the level of hs-cTnI,the patients were divided into the elevated level group(hs-cTnI>0.034 ng/mL in male and hs-cTnI>0.016 ng/mL in female)and the normal level group.All of the patients were followed up once every 6 months.Adverse cardiovascular events were cardiogenic death and heart failure hospitalization.Results:The mean follow-up period was 36.2±7.9 months.Cardiogenic mortality(18.6%[26/140]vs.1.5%[5/330],P<0.001)and heart failure(HF)hospitalization rate(74.3%[104/140]vs.43.6%[144/330],P<0.001)were significantly higher in the elevated level group.The Cox regression analysis showed that the elevated level of hs-cTnI was a predictor of cardiogenic death(hazard ratio[HR]:5.578,95%confidence interval[CI]:2.995-10.386,P<0.001)and HF hospitalization(HR:3.254,95%CI:2.698-3.923,P<0.001).The receiver operating characteristic curve demonstrated that a sensitivity of 72.6%and specificity of 88.8%for correct prediction of adverse cardiovascular events when a level of hs-cTnI of 0.1305 ng/mL in male and a sensitivity of 70.6%and specificity of 90.2%when a level of hs-cTnI of 0.0755 ng/mL in female were used as the cut-off value.Conclusion:Significant elevation of hs-cTnI(≥0.1305 ng/mL in male and≥0.0755 ng/mL in female)is an effective indicator of the increased risk of cardiogenic death and HF hospitalization in heart failure with preserved ejection fraction patients.

Value of transthoracic echocardiography combined with cardiac troponin I in risk stratification in acute pulmonary thromboembolism

Background Acute pulmonary thromboembolism （APE） causes right ventricular dysfunction （RVD） and cardiac troponin I （cTnl） elevation. Patients with RVD and cTnl elevation have a worse prognosis. Thus, early detection of RVD and cTnl elevation is beneficial for risk stratification. In this study, we assessed 14-day adverse clinical events and combined RVD on transthoracic echocardiography （TTE） with cTnl in risk stratification among a broad spectrum of APE patients. Methods The prospective multi-centre trial included 90 patients with confirmed APE from 12 collaborating hospitals. Acute RVD on TTE was diagnosed in the presence of at least 2 of the following： right ventricular dilatation （without hypertrophy）, loss of inspiratory collapse of inferior vena cava （IVC）, right ventricular （RV） hypokinesis, tricuspid regurgitant jet velocity 〉2.8 m/s. The study patients were divided into two groups according to clinical and echocardiographic findings at presentation： Group Ⅰ： 50 patients with RVD; Group Ⅱ：40 patients without RVD. Results More than half of the patients （50/90, 55.6%） had RVD. Nearly one third （26/90, 28.9%） of patients had elevated cTnl at presentation and only 4.2% on the fourth day after initial therapy. A multiple Logistic regression model implied RVD, right and left ventricular end-diastolic diameter ratio （RVED/LVED）, and cTnl independently predict an adverse 14-day clinical outcome （P〈0.01）. Receiver operating characteristics （ROC） curves revealed that the cut-off values of RVED/LVED and cTnl yielding the highest discriminating power were 0.65 and 0.11 ng/ml, respectively. Furthermore, the incidence of an adverse 14-day clinical event in patients with RVD and elevated cTnl was greater （40.7%） than in patients with elevated cTnl or positive RVD alone （0% and 8.3%, respectively） （P〈0.001）. Conclusions RVD, RVED/LVED, and cTnl are independent predictors of 14-day clinical outcomes. The patients with RVED/LVED greater than 0.65 and cTnl higher than 0.11 ng/ml at presentation possibly have adverse 14-day events. RVD combined with cTnl can identify a subgroup of APE patients with a much more guarded prognosis.

Intranuclear cardiac troponin I plays a functional role in regulating Atp2a2 expression in cardiomyocytes

In the past studies,it is shown that cardiac troponin I(cTnI,encoded by TNNI3),as a cytoplasmic protein,is an inhibitory subunit in troponin complex,and involves in cardiomyocyte diastolic regulation.Here,we assessed a novel role of cTnI as a nucleoprotein.Firstly,the nuclear translocation of cTnI was found in mouse,human fetuses and rat heart tissues.In addition,there were differences in percentage of intranuclear cTnI in different conditions.Based on weighted gene co-expression network analyses(WGCNA)and verification in cell experiments,a strong expression correlation was found between TNNI3 and Atp2a2,which encodes sarco-endoplasmic reticulum Ca2t ATPase isoform 2a(SERCA2a),and involves in ATP hydrolysis and Ca2t transient.TNNI3 gain and loss caused Atpa2a2 increase/decrease in a dosedependent manner both in mRNA and protein levels,in vivo and in vitro.By using ChIP-sequence we demonstrated specific binding DNA sequences of cTnI were enriched in ATP2a2 promoter239we889 region and the specific binding sequence motif of cTnI was analyzed by software as"CCAT",which has been reported to be required for YY1 binding to the promoter region of YY1-related genes.Moreover,it was further verified that pcDNA3.1()-TNNI3 could express cTnI proteins and increase the promoter activity of Atp2a2 through luciferase report assay.In the end,we evaluated beat frequencies,total ATP contents,Ca2t transients in TNNI3-siRNA myocardial cells.These findings indicated,for the first time,cTnI may regulate Atp2a2 in cardiomyocytes as a co-regulatory factor and participate in the regulation of intracellular Ca ions.

超声心动图联合血清cTnI、GDF-15检测对老年乳腺癌患者术后化疗心脏损伤的评估价值

目的探究超声心动图联合血清心肌肌钙蛋白I(cTnI)、生长分化因子-15(GDF-15)对老年乳腺癌(BC)患者术后化疗心脏损伤的评估价值。方法选取北京市大兴区人民医院2019年9月至2022年8月收治的112例老年BC术后应用表柔比星为主的化疗患者为研究对象,按照是否发生心脏损伤将其分为:心脏损伤组(40例)和心脏未损伤组(72例)。评估超声心动图对老年BC患者术后化疗心脏损伤的诊断价值;采用酶联免疫吸附法检测两组血清cTnI、GDF-15水平;采用受试者工作特征曲线评估血清cTnI、GDF-15对老年BC患者术后化疗心脏损伤的诊断价值;以心脏损伤判定标准为金标准,评价超声心动图、血清cTnI、GDF-15及三者联合对老年BC患者术后化疗心脏损伤的诊断价值。结果超声心动图诊断老年BC患者术后化疗心脏损伤的灵敏度、特异度、准确度分别为77.50%、88.89%、84.82%;心脏损伤组患者血清cTnI、GDF-15水平均明显高于心脏未损伤组(P<0.05);血清cTnI、GDF-15诊断老年BC患者术后化疗心脏损伤的曲线下面积分别为0.864、0.834,截断值分别为221.88 ng/L、8.06 ng/L,灵敏度分别为75.00%、80.00%,特异度分别为94.44%、87.50%,准确度分别为87.50%、84.82%;超声心动图联合血清cTnI、GDF-15诊断老年BC患者术后化疗心脏损伤的灵敏度、特异度、准确度分别为97.50%、86.11%、90.18%,优于单独诊断。结论超声心动图联合血清cTnI、GDF-15对老年BC患者术后化疗致心脏损伤有较高诊断价值,可有效提高灵敏度、准确度,具有较高特异度。

深静脉血栓形成患者下肢深静脉血栓密度、血清cTnI、Hcy水平与合并肺栓塞风险的关系研究

目的探讨深静脉血栓(DVT)形成患者下肢深静脉血栓密度、血清心肌肌钙蛋白I(cTnI)及同型半胱氨酸(Hcy)水平与合并肺栓塞风险的关系。方法回顾性分析2016年1月至2019年1月在秦皇岛市第一医院进行治疗的108例DVT患者,依据是否合并肺栓塞分为对照组(单纯DVT)68例,观察组(DVT合并肺栓塞)40例。收集两组基线资料[年龄、性别、高血压史、高血脂史、慢性肺部疾病、脑血管意外、下肢骨折、吸烟史、饮酒史、血栓受累肢体、受累静脉、下肢深静脉血栓密度比、wells评分、血小板计数(PLT)、中性粒细胞计数(NEUT)、C反应蛋白(CRP)、D二聚体(D-D)、cTnI及Hcy水平]并进行比较,分析DVT合并肺栓塞的影响因素。根据肺栓塞危险程度将DVT合并肺栓塞患者划分为高危组(n=10)、中危组(n=17)、低危组(n=13);比较不同危险程度肺栓塞间下肢深静脉血栓密度、血清cTnI、Hcy水平及wells评分间差异。分析下肢深静脉血栓密度、血清cTnI及Hcy水平与wells评分的关系。结果两组患者年龄、性别、高血压、高血脂、慢性肺部疾病、脑血管意外、下肢骨折、吸烟史、饮酒史、血栓受累肢体及受累静脉比较,差异均无统计学意义(P>0.05);观察组下肢深静脉血栓密度比、wells评分、PLT、NEUT、CRP、D-D、cTnI及Hcy水平分别为(52.37±12.19)%、(5.16±1.07)分、(284.63±90.72)×10^(9)/L、(71.22±10.16)%、(15.29±2.39)mg/L、(1051.27±271.19)ng/mL、(0.33±0.13)ng/mL、(21.27±2.16)μmol/L,均高于对照组[41.67±10.28)%、(3.28±0.94)分、(206.27±86.15)×10^(9)/L、(64.31±8.75)%、(10.33±1.71)mg/L、(739.52±206.34)ng/mL、(0.21±0.06)ng/mL、(10.19±1.75)μmol/L],差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,下肢深静脉血栓密度比、wells评分、cTnI及Hcy为DVT合并肺栓塞的独立预测因子(P<0.05)。肺栓塞低危组下肢深静脉血栓密度比、cTnI、Hcy水平及wells评分均低于中危组、高危组,差异均有统计学意义(P<0.05)。经Spearman相关性分析,下肢深静脉血栓密度比、cTnI、Hcy水平与wells评分呈正相关(P<0.05)。结论DVT患者下肢深静脉血栓密度、血清cTnI、Hcy可有效预测合并肺栓塞,同时可判断患者肺栓塞严重程度。

The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/contemporary cardiac troponin for the early diagnosis of acute myocardial infarction

BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(c Tn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the c Tn assays:the point-of-care c Tn(POC-c Tn)group,the contemporary c Tn(c-c Tn)group,and hs-c Tn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-c Tn/c-c Tn assays,combining CK-MB and POC-c Tn/c-c Tn increased the diagnostic sensitivity of AMI(56.1%vs.63.9%,P<0.001;82.7%vs.84.3%,P=0.025).In contrast,combining CK-MB and hs-c Tn did not change the sensitivity compared with hs-c Tn alone(95.0%vs.95.0%,P>0.999).In the subgroup analysis,the sensitivity of combining CKMB and c-c Tn increased with time from symptom onset<6 h compared with c-c Tn alone(72.8%vs.75.0%,P=0.046),while the sensitivity did not increase with time from symptom onset>6 h(97.5%vs.98.3%,P=0.317).The AUC of the combination of CK-MB and POC-c Tn significantly increased compared to the single POC-c Tn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CKMB and c-c Tn/hs-c Tn assays did not significantly decrease compared with that of the single c-c Tn/hs-c Tn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-c Tn or c-c Tn may be valuable for the early diagnosis of AMI,especially when hs-c Tn is not available.

Comparison of plasma microRNA-1 and cardiac troponin T in early diagnosis of patients with acute myocardial infarction

BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.

基于CDs@SiNWs的光电化学免疫传感器构建及性能研究

采用金属辅助化学蚀刻法制备高定向硅纳米线阵列(silicon nanowire arrays, SiNWs),结合碳点(carbon dots,CDs)改性制备了一种新型无标记光电免疫传感器,用于心肌肌钙蛋白I(cardiac troponin I, cTnI)的检测。N型SiNWs作为光阳极,可获得强的光电信号基底响应。采用旋涂法将CDs负载于SiNWs表面,可以提高SiNWs对可见光的吸收能力,促进光生载流子分离,从而提高SiNWs的光电性能;同时,CDs为抗体连接提供了羧基活性位点。基于CDs@SiNWs的光电免疫传感器对cTnI的检测具有良好的线性范围(0.005~5.000 ng/mL)和较低的检出限(3.79 pg/mL)。所设计的光电化学(photoelectrochemical, PEC)免疫传感器具有良好的灵敏度、稳定性和重复性。该电极可实现无标签检测,为实现c TnI的即时检测提供了新的途径。

冠心病心律失常的危险因素及cTnI、NT-proBNP、MMP-9的预测价值

目的:探讨冠心病患者发生心律失常的危险因素及心肌肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)对心律失常的预测价值。方法:选取110例冠心病治疗后发生心律失常的患者作为心率失常组;选取同期150例冠心病治疗后心律正常患者作为无心律失常组。对冠心病患者心律失常发生相关变量进行单因素、多因素Logistic回归分析。分析cTnI、NT-proBNP、MMP-9指标水平对心律失常的预测价值。结果:单因素分析显示,两组患者年龄、体质量、纽约心脏病协会(NYHA)分级、吸烟史、合并糖尿病、病变部位、合并慢性阻塞性肺疾病(COPD)、cTnI、NT-proBNP、MMP-9均有统计学差异(P<0.05)。多因素Logistic回归分析显示,年龄≥60岁、体质量≥60 kg、NYHA分级Ⅲ~Ⅳ级、存在吸烟史、合并糖尿病、右冠状动脉、合并COPD、cTnI≥4.50μg/L、NT-proBNP≥280 ng/L、MMP-9≥180μg/L均是影响冠心病患者发生心律失常的主要危险因素。ROC曲线显示,联合检测预测心律失常诊断效能高于cTnI、NT-proBNP、MMP-9单一检测。结论:cTnI、NT-proBNP、MMP-9是影响冠心病患者发生心律失常的主要关键性危险因素,三者对心律失常均具有较好的预测价值。

Impact of training specificity on exercise-induced cardiac troponin elevation in professional athletes: A pilot study

BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise,but data on intermittent exercise are scarce.It has not been investigated whether cardiac troponin elevation is influenced depending on the type of exercise that an athlete is adapted to perform.We hypothesized that intermittent but not continuous exercise induces cardiac troponin elevation in professional athletes adapted to high-intensity intermittent exercise.AIM To examine how training specificity impacts high-sensitivity cardiac troponin T(hs-cTnT)release.METHODS Nine professional floorball players participated in the study,which comprised two different exercise tests:a continuous incremental cycle ergometer test and a Yo-Yo Intermittent Recovery 2(Yo-Yo IR2)test.Serial assessment of hs-cTnT was performed after the cycle ergometer test and the Yo-Yo IR2 test(baseline,0,2,6,and 24 h).RESULTS No hs-cTnT elevation above the myocardial damage cutoff(≥14 ng/L)was shown after the cycle ergometer test,whereas hs-cTnT levels rose over the cutoff in three of nine participants after the Yo-Yo IR2 test.The hs-cTnT levels peaked at 6 h after both tests,but were significantly higher after the Yo-Yo IR2 test compared to the cycle ergometer test(median hs-cTnT concentration 10.6 ng/L vs 7.8 ng/L,P=0.038).All levels returned to baseline within 24 h.CONCLUSION In professional athletes adapted to high-intensity intermittent exercise,hs-cTnT was significantly elevated after intermittent but not continuous exercise.This principle of specificity training should be considered when designing future studies to avoid misinterpretation of hs-cTnT elevation.

BNP联合cTnI、MYO检测在急性心肌梗死患者早期诊断中的应用价值

目的探究脑钠肽(Brain Natriuretic Peptide,BNP)联合心肌肌钙蛋白I(Cardiac Troponin I,cTnI)、肌红蛋白(Myoglobin,MYO)检测在急性心肌梗死早期诊断中的价值。方法回顾性选取2022年3月—2023年3月青岛市即墨区第二人民医院收治的115例急性心肌梗死患者及同期65名健康体检人员的临床资料。将115例急性心肌梗死患者设为观察组,65名健康体检人员设为对照组。所有研究对象均进行BNP、cTnI、MYO检测。对比两组各指标水平,分析各指标单独及联合检测急性心肌梗死的诊断价值。结果观察组BNP、cTnI、MYO水平均高于对照组,差异有统计学意义(P均<0.05)。BNP、cTnI、MYO联合检测的特异度、灵敏度、准确度分别为92.31%、88.70%、90.00%,高于各项指标单独检测。结论急性心肌梗死患者与健康人员体内的BNP、cTnI、MYO水平均存在较大差异,且使用上述3项指标进行联合检测的诊断效能较高,可作为临床治疗的参考依据。

联合检测血清Hcy、CTnI、TG/HDL-C、Lp(a)在冠心病中的诊断价值分析

目的:分析血清同型半胱氨酸(Hcy)、心肌肌钙蛋白I (CTnI)、甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)、脂蛋白(a)[LP (a)]联合检测诊断冠心病的效能。方法:选取2021年5月—2022年5月郑州市第九人民医院收治的63例冠心病患者纳入观察组,另将同期于医院体检的54例健康人群纳入对照组。采集两组受试者静脉血,检测对比其Hcy、CTnI、TG/HDL-C、Lp (a)的差异。另绘制受试者ROC曲线,分析Hcy、CTnI、TG/HDL-C、Lp (a)单独或联合检测诊断冠心病的效能。结果:观察组患者Hcy、CTnI、TG/HDL-C、LP (a)高于对照组,差异有统计学意义(t=21.556、35.837、11.090、45.618,P<0.05);ROC结果显示,Hcy、CTnI、TG/HDL-C、Lp (a)联合检测的曲线下面积(AUC)为0.916,高于单独检测的0.807、0.869、0.846、0.810。结论:Hcy、CTnI、TG/HDL-C、Lp (a)在冠心病患者机体内呈异常表达,联合检测可于早期诊断出冠心病。

血清Myo、cTnI、NT-proBNP、心肌酶谱水平联合检测在心肌梗死诊断中的价值

目的:分析血清肌红蛋白(Myo)、肌钙蛋白I(cTnI)、N-末端脑钠肽前体(NT-proBNP)、心肌酶谱[肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌酸激酶(CK)]水平联合检测在心肌梗死诊断中的价值。方法:选取2021年5月至2023年5月郑州市惠济区人民医院收治的78例心肌梗死患者进行横断面研究,设为观察组;选取同期该院收治的78例冠心病非心肌梗死患者进行横断面研究,设为对照组。比较两组血清Myo、cTnI、NT-proBNP、CK-MB、LDH、CK水平;采用受试者工作特征(ROC)曲线分析血清Myo、cTnI、NT-proBNP、CK-MB、LDH、CK水平单项及联合检测诊断心肌梗死的价值。结果:观察组血清Myo、cTnI、NT-proBNP、CK-MB、LDH、CK水平均高于对照组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,血清Myo、cTnI、NT-proBNP、CK-MB、LDH、CK水平单项及联合检测诊断心肌梗死的曲线下面积(AUC)分别为0.700、0.750、0.780、0.846、0.600、0.869、0.923,均有一定的诊断价值,其中联合检测的诊断价值高于六者单项检测诊断。结论:血清Myo、cTnI、NT-proBNP、CK-MB、LDH、CK水平联合检测诊断心肌梗死的价值高于六者单项检测诊断。

血清hs-cTnI、CK-MB、NT-proBNP水平与冠心病患者心肌缺血程度、病情严重程度的相关性

目的:分析血清高敏肌钙蛋白I(hs-cTnI)、肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-proBNP)水平与冠心病患者心肌缺血程度、病情严重程度的相关性。方法:回顾性分析2020年1月至2023年1月该院收治的136例冠心病患者的临床资料,设为观察组,另选取同期136名健康体检者设为对照组,比较两组血清hs-cTnI、CK-MB、NT-proBNP水平,并采用Gensini评分评估心肌缺血程度,比较不同冠状动脉狭窄程度、病情严重程度冠心病患者血清hs-cTnI、CK-MB、NT-proBNP水平,分析血清hs-cTnI、CKMB、NT-proBNP水平与心肌缺血程度、病情严重程度的相关性。结果:观察组血清hs-cTnI、CK-MB、NT-proBNP水平均高于对照组,差异有统计学意义(P<0.05);不同冠状动脉狭窄程度冠心病患者血清hs-cTnI、CK-MB、NT-proBNP水平,轻度狭窄患者<中度狭窄患者<重度狭窄患者,差异均有统计学意义(P<0.05);不同美国纽约心脏病协会(NYHA)心功能分级冠心病患者血清hs-cTnI、CK-MB、NTproBNP水平,Ⅰ级<Ⅱ级<Ⅲ级<Ⅳ级,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,血清hs-cTnI、CK-MB、NTproBNP水平与冠心病患者心肌缺血程度、病情严重程度均呈正相关(r>0,P<0.05)。结论:血清hs-cTnI、CK-MB、NT-proBNP水平与冠心病患者心肌缺血程度、病情严重程度均呈正相关。

Comparison of serum cardiac troponin-Ⅰ and creatine kinase MB isoenzyme concentrations in asphyxiated neonates

Objective:To assess the correlation of signs of myocardial damage to serum cardiac troponin I(cTnI)and creatine kinase MB isoenzyme(CK-MB)concentrations.Methods:Blood samples were collected from 25 term asphyxiated neonates and 25 controls at 12 h of age by immunoassay.The asphyxiated neonates were followed up until discharge or death.Results:Asphyxiated neonates had significantly higher concentrations of cTnI and CK-MB than controls(P<0.001).Serum cTnI concentrations were significantly higher in asphyxiated neonates who developed hypotension,heart failure or those had low ejection fraction(P<0.01).Serum cTnI concentrations were significantly higher in asphyxiated who died than those who survived(P<0.01).There was no significant difference in serum CK-MB mass concentrations between asphyxiated neonates with and without these complications.Conclusion:Unlike CK-MB,serum cTnI concentrations are significantly higher in asphyxiated neonates who died or developed cardiac dysfunction.

新生儿缺血缺氧性脑病患儿cTnI、CK-MB、IL-6及hs-CRP表达水平及意义

目的探讨新生儿缺血缺氧性脑病(HIE)患儿心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、白细胞介素-6(IL-6)及超敏C-反应蛋白(hs-CRP)表达水平及意义。方法选取2019年2月—2021年11月本院收治的90例HIE患儿作为病例组,另选取同期健康体检新生儿66例作为对照组,采用酶联免疫吸附法(ELISA)检测两组患者血清cTnI、CK-MB、IL-6及hs-CRP水平,分析cTnI、CK-MB、IL-6、hs-CRP表达差异及其与HIE严重程度和预后的诊断价值。结果重度组患儿血清cTnI、CK-MB、IL-6及hs-CRP水平高于轻度组和中度组(P<0.05);Spearman相关性分析显示,cTnI表达与CK-MB、IL-6及hs-CRP表达呈正相关(P<0.05),CK-MB表达与IL-6、hs-CRP表达呈正相关(P<0.05),IL-6表达与hs-CRP表达呈正相关(P<0.05);预后不良组患儿血清cTnI、CK-MB、IL-6及hs-CRP水平高于预后良好组(P<0.05);ROC曲线分析显示,cTnI、CK-MB、IL-6、hs-CRP联合预测HIE预后的AUC为0.937高于cTnI的0.702、CK-MB的0.831、IL-6的0.774,hs-CRP的0.743(P<0.05)。结论HIE患儿血清cTnI、CK-MB、IL-6及hs-CRP随着病情加剧表达升高,可用于预后诊断。

Effect of Cardioplegia for Myocardial Protection in Pediatric Cardiac Surgery:A Network Meta-Analysis

Cardioplegia has been widely used to reduce myocardial injury during pediatric cardiac surgery;however,which cardioplegia solution has the best protective effect has not been established.Thus,we compared the myocardial protective effects of different cardioplegia solutions used in pediatric cardiac surgery.Seven databases were searched to identify the relevant randomized controlled trials.A network meta-analysis with a Bayesian framework was conducted.The outcomes included the following biochemical and clinical outcomes:serum concentrations of the creatine kinase-myocardial band at 6 h postoperatively;cardiac troponin I(cTnI)at 4,12,and 24 h postoperatively;spontaneous beating after declamping;postoperative arrhythmias;inotropic support percentage and duration;mechanical ventilation hours;intensive care unit stay in days;hospital stay in days;and mortality.The group treated with cold crystalloid cardioplegia(cCCP)was chosen as the control group.The 22 studies involved 1529 patients.Six types of cardioplegia solutions were described in these studies,including cold blood cardioplegia,cCCP,del Nido,histidine-tryptophan-ketoglutarate(HTK),terminal warm blood cardioplegia,and warm blood cardioplegia(wBCP).The serum concentrations of the 24-h cTnI with wBCP(MD=−2.52,95%CI:−4.74 to−0.27)was significantly lower than cCCP.The serum concentrations of the 24-h cTnI with HTK(MD=4.91,95%CI:2.84–7.24)was significantly higher than cCCP.There was no significant difference in other biochemical and clinical outcomes when compared to cCCP.In conclusion,wBCP may have a superior myocardial protective effect with lower 24-h cTnI levels postoperatively and similar clinical outcomes after pediatric cardiac surgery.