Ali GÜÇTEKİN, Mehmet AVCIKÜÇÜK, Canan TOPÇUOĞLU, Fatih BAKIR

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Akut koroner sendromda troponin T ve troponin I

Amaç: Troponinler, tropomiyozin ile birlikte iskelet ve kalp kası kasılmasının düzenlenmesinde rol alan yapısal proteinlerdir ve kalp kası hasarının duyarlı ve özgül belirteci oldukları bilinmektedir. Bu çalışmada, akut koroner sendromun erken dönem tanısında serum Troponin T ve Troponin I düzeylerinin duyarlılık, özgüllük, pozitif ve negatif tahmini değerler yönünden karşılaştırılması amaçlanmıştır. Ayrıca akut myokart infarktüsünün erken döneminde (ilk altı saat içinde) troponinlerin kullanımı araştırılmıştır. Yöntem: Çalışmamıza, Ankara Numune Eğitim ve Araştırma Hastanesi Acil Servisine göğüs ağrısı şikayetiyle başvuran ve kardiyoloji bölümünce izlemi yapılan 18-90 (ortalama 60,42) yaşları arasında 176 kişi dâhil edilmiştir. Serum troponin I düzeyleri Dade Behring Dimension analizöründe (Siemens Healthcare Diagnostics, Deerfield, IL, USA), troponin T düzeyleri Elecsys 2010 analizöründe (Roche Diagnostics, Basel, Switzerland) ölçülmüştür. Bulgular: Troponin I için kesme noktası 1.84 ng/ml olarak belirlenmiş; duyarlılığı %80, özgüllüğü %90,9, pozitif tahmini değeri %80, negatif tahmini değeri %90,9 olarak bulunmuştur. Troponin T için kesme noktası 0,051 ng/ml olarak belirlenmiş; duyarlılığı %92,7, özgüllüğü %70,2, pozitif tahmini değeri %58,6, negatif tahmini değeri %95,5 olarak bulunmuştur. Myokart infarktüsü grubunu kontrol ve myokart infarktüsü dışı grubundan ayırt etmede ROC eğrisinde eğri altında kalan alan, troponin I’da 0,914 (0,871- 0,957) olarak, troponin T’de ise 0,887 (0,835- 0,939) olarak belirlenmiştir. Sonuç: Çalışmamıza göre akut myokart infarktüsü tanısı konan hasta serumlarında troponin I’nın özgüllüğü troponin T’den daha yüksek, troponin T’nin duyarlılığının ise troponin I’dan daha yüksek bulunmuştur. Ancak troponin T’nin yalancı pozitifliği de troponin I’dan daha yüksek olarak belirlenmiştir.

Troponin T and troponin I at acut coronary sendrom

Objective: Troponins and tropomyosins are not only the structural proteins that play roles in arrangement of skeletal and heart muscles, but also sensitive and spesific markers of heart muscle damage. In this study we aimed to compare the values of sensitivity, specifity, positive and negative predictive values of troponin T and troponin I which were used to early diagnose of acute coronary syndrome. We also investigated the useability of troponins in diagnoses of the early stage (first 6 hours) of acute myocardial infarction. Method: In our study, 176 patients between the ages 18- 90 (average is 60,42) admitted to emergency unit of Training and Research Hospital of Ankara Numune Cardiology Unit with chest pain were investigated. Serum troponin I and serum troponin T levels were analysed by Dade Behring Dimension (Siemens Healthcare Diagnostics, Deerfield, IL, USA) and by Elecsys 2010 analyser (Roche Diagnostics, Basel, Switzerland), respectively. Results: For Troponin I cut of point was calculated as 1.84 ng/ml. Sensitivity 80%, spesifity 90.9% positive and negative predictive values were obtained as 80% and 90.9% respectively. For troponin T cut of point was calculated as 0.051 ng/ml. Sensitivity is 92.7%, spesifity 70.2%, positive and negative predictive values were obtained 58.6% and 95.5% respectively. In order to differantiate MI group with non- MI and control groups; the area under the ROC curve was 0.914 (0.871-0.957) for troponin I and 0.887 (0.835- 0.939)for troponin T. Conclusion : According to our study; in the patients who get the diagnosis of AMI we observed troponin I spesitivity is higher than troponin T but troponin T sensitivity is higher than Troponin I. We also observed that troponin false positive ratio was found higher than troponin I.
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Türk Hijyen ve Deneysel Biyoloji Dergisi-Cover
  • ISSN: 0377-9777
  • Başlangıç: 1938
  • Yayıncı: Türkiye Halk Sağlığı Kurumu
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