文档介绍：心肌损伤标志IDEALMARKERFOUNDONLYINTISSUEOFINTERESTHIGHGRADIENTALLOWSEARLYDETECTIONDETECTIONOFMARKERALLOWSINTERVENTIONTHATPREVENTSORMINIMIZESEFFECTSOFDISEASE10/992MYOCARDIALINJURYIRREVERSIBLEINJURYTYPICALLYREQUIRES30MINUTESOFISCHEMIACHRONICO2DEFICIENCYMAKESCELLSMORERESISTANTAFTER30-60MIN,CELLDEATHSTARTS;80%OFCELLSATRISKDIEWITHIN3HOURS,ALMOST100%BY6HOURSOFISCHEMIA10/993SPECTRUMOFISCHEMIANoSymptomsCLOTACUTECORONARYSYNDROMES:Q-WAVEMINON-QMIUNSTABLEANGINACrescendoAnginaANGINA10/ellsalreadydead0123456HoursofIschemia10/995IDEALCARDIACMARKERDETECTSONLYCARDIACDAMAGEDETECTABLEWHILEDAMAGEREVERSIBLEORPREVENTABLECORRELATESWITHAMOUNTOFINJURYPREDICTSPROGNOSISCHEAP,RAPIDLYMEASURED10/996MYOCARDIALCONTENTSWITHCELLDEATH,HOLESDEVELOPINCELLMEMBRANECONTENTSLEAKDEPENDENTONSIZE,SOLUBILITYSMALL,PLEXEDMARKERSRELEASEDSLOWLY10/997RELEASEMECHANISMSTANDARDTEACHING-MARKERSONLYRELEASEDWITHIRREVERSIBLEINJURYBECAUSEMARKERSAREPROTEINS,WILLNOTLEAKWITHISCHEMIAMARKERRELEASE=CELLDEATH10/998RELEASEMECHANISMFENGetal.,AJClinPathol1998;110:PAREDTO5CONTROLSMEASUREDTnI,MYO,CKMBSTUDIEDMYOCARDIUMBYBIOPSYANDAUTOPSYWITHGROSS,MICRO,HISTOCHEMISTRY,EM10/999RELEASEMECHANISMWITHSTENOSIS,8PIGSHADNECROSIS,4NONECROSIS(ONLYEMLESIONS)ALLMARKERSWENTUPAFTERINDUCTIONOFISCHEMIAINBOTHGROUPS;ONLYTnISIGNIFICANTLYHIGHERTHANCONTROLINNECROSISANDISCHEMIA(HIGHERINFORMER)10/9910