Posterske teme Poster topics - Biochemia Medica
Posterske teme Poster topics - Biochemia Medica
Posterske teme Poster topics - Biochemia Medica
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P4-3 Srce i srčani biljezi<br />
gnostičko značenje izoenzima MB kreatin kinaze i srčanog<br />
troponina I (cTnI) u krvi bolesnika s akutnim infarktom miokarda.<br />
U studiju je bilo uključeno 36 bolesnika s akutnim<br />
infarktom miokarda (20 muškaraca,16 žena, starosti 61±14<br />
godina). Koncentracija cTnI i aktivnost CK-MB u serumu je<br />
određivana u tri vremenska razdoblja (6-9 sati, 24 sata i 6-<br />
7 dana) od početka bolova u prsištu. Srčani TnI je određivan<br />
fl uoroenzimometrijski na analizatoru AxSYM (Abbott<br />
Laboratories). CK-MB aktivnost je određivana metodom<br />
inhibicije enzima (Chronolab) na analizatoru Flexor. Oba<br />
biljega su imala maksimalne vrijednosti u krvi 24 sata od<br />
početka simptoma infarkta. U usporedbi sa CK-MB, cTnI<br />
je imao bolju osjetljivost u sva tri razdoblja određivanja.<br />
Dakle, visok sadržaj cTnI u srcu čini ga idealnim biljegom<br />
za otkrivanje minimalnog oštećenja miokarda. Dugo trajanje<br />
povećanih vrijednosti cTnI čini ga idealnim biljegom<br />
za kasno dijagnosticiranje akutnog infarkta miokarda.<br />
E-mail: medical_biochemistry@hotmail.com<br />
P4-4<br />
Vrijednost koncentracije cTnI i Myo u ranoj<br />
procjeni srčanog zatajenja u hitnoj službi<br />
Hrabrić S, Bilić-Zulle L, Dvornik Š<br />
Klinički bolnički centar Rijeka, Rijeka, Hrvatska<br />
Bol u prsima je jedan od najčešćih razloga zbog kojeg<br />
bolesnici dolaze u hitnu medicinsku službu i od velike je<br />
važnosti pravodobno prepoznati znakove srčanog zatajenja<br />
kako bi se moglo reagirati na vrijeme. Mjerenjem kombinacije<br />
ranog i kasnog biljega moglo bi se lakše i brže<br />
isključiti srčano zatajenje i tako omogućiti otpuštanje<br />
onih bolesnika koji ne zahtijevaju prijam u bolnicu ili duže<br />
promatranje. Cilj studije je bio ocijeniti vrijednost serumske<br />
koncentracije mioglobina (Myo) i srčanog troponina<br />
I (cTnI) u ranoj procjeni bolesnika koji su imali simptome<br />
boli u prsima kada su došli u hitnu medicinsku službu.<br />
Uzorci krvi su vađeni odmah nakon dolaska bolesnika i<br />
koncentracija srčanih biljega mjerena je u hitnom laboratoriju.<br />
Odredili smo osjetljivost, specifi čnost i površinu<br />
ispod krivulje ROC za cTnI i Myo kod 916 bolesnika koji su<br />
pristupili u hitnu službu. Osjetljivost za serumsku koncentraciju<br />
cTnI i Myo bila je 30% i 42% za svaki pojedinačno,<br />
specifi čnost je bila viša, tj. 96% i 83%, pozitivna prediktivna<br />
vrijednosti 77% i 52%, a negativna prediktivna vrijednost<br />
77% za oba biljega. Površina ispod krivulje ROC s<br />
graničnim vrijednostima od 0,2 µg /L za cTnI i 92 µg /L za<br />
Myo je bila slična, 0,674 i 0,671. Ne postoji značajna razlika<br />
<strong>Biochemia</strong> <strong>Medica</strong> 2006;16(Suppl 1):S1–S268<br />
S120<br />
the relative increase and diagnostic signifi cance of blood<br />
creatine kinase MB isoenzyme (CK-MB) and cardiac troponin<br />
I (cTnI) in AMI patients. Thirty-six AMI patients (20<br />
male and 16 female, aged 61±14 years) were included in<br />
the study. We measured serum concentrations of cTnI and<br />
activities of CK-MB in three time periods (6-9 h, 24 h and<br />
6 -7 days) from chest pain onset. Cardiac troponin I was<br />
measured by the fl uoroenzymometric method on an Ax-<br />
SYM analyzer (Abbott Laboratories). The enzyme inhibition<br />
method (Flexor analyzer) was used for CK-MB activity<br />
(Chronolab). Both markers showed maximal blood level<br />
at 24 h of the onset of infarction symptoms. As compared<br />
with CK-MB, cTnI showed higher sensitivity in all three periods<br />
of measurement. Thus, high heart tissue content of<br />
cTnI makes it an ideal marker for the detection of minimal<br />
myocardial damage, whereas prolonged elevation of cTnI<br />
level makes it an ideal marker for late AMI diagnosing.<br />
E-mail: medical_biochemistry@hotmail.com<br />
P4-4<br />
The value of cTnI and Myo concentration<br />
in the early assessment of heart failure at<br />
emergency department<br />
Hrabrić S, Bilić-Zulle L, Dvornik Š<br />
Rijeka University Hospital, Rijeka, Croatia<br />
Heart and cardial markers<br />
Chest pain is one of the most common complaints presented<br />
to emergency department (ED) and rapid decision<br />
depends on several factors including values of biochemical<br />
cardiac markers. The value of biochemical markers in<br />
diagnostic procedu re lies in its ability to provide more information<br />
to the clinician within short time, when prompt<br />
decision is necessary. The use of a combination of an early<br />
and late marker may facilitate rapid exclusion of heart failure<br />
and enable discharge of patients who do not require<br />
hospital admission or prolonged observation. The aim<br />
of study was to evaluate the value of serum myoglobin<br />
(Myo) and cardiac troponin I (cTnI) in the early assessment<br />
of patients presenting to ED with the symptoms of chest<br />
pain. Blood samples were obtained immediately upon<br />
patient arrival to ED. Serum concentrations of the two<br />
cardiac markers were determined at emergency laboratory.<br />
We determined the sensitivity, specifi city, receiver<br />
operating characteristics (ROC) curve for cTnI and Myo<br />
in 916 patients upon their admission to ED. Serum concentrations<br />
of cTnI and Myo demonstrated a sensitivity of<br />
30% and 42%, higher specifi city of 96% and 83%, positive<br />
predictive value of 77% and 52%, respectively, and nega-
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