diplomska naloga
Blaž Marčič (Author), Joško Osredkar (Mentor)

Abstract

Srčno-žilna obolenja so v Sloveniji, kot tudi drugod po svetu, najpogostejši vzrok umrljivosti in obolevanosti. Srčno-žilne bolezni so najpogosteje posledica sprememb v koronarnih arterijah, predvsem zaradi ateroskleroze. To so ishemične bolezni srca, med katerimi je najpogostejši vzrok smrti akutni miokardni infarkt (AMI). Obolevanje zaradi AMI iz leta v leto narašča, zato je za preprečevanje dodatnih zapletov, ki sledijo nastanku AMI, potrebna takojšnja obravnava bolnika in s tem hitra ter natančna diagnostika. V preteklosti sta bila glavna biokemična markerja nekroze srčne mišice kreatin kinaza in za srčno mišico bolj specifičen izoencim kreatin kinaze (CK-MB). Leta 2000 pa je delovna skupina Evropskega kardiološkega združenja in Ameriškega inštituta za kardiologijo (ESC/ACC task force) predlagala uporabo srčnega troponina (cTnI in cTnT) kot preferenčnega biokemičnega markerja za diagnozo ishemične bolezni srca. Določanje cTn danes predstavlja najbolj specifičen in občutljiv diagnostični test za odkrivanje okvar srčne mišice. V sklopu raziskave smo z dvema različnima kemiluminiscenčnima metodama (DiaSorin Liaison® Troponin I in Bayer ADVIA Centaur® TnI-Ultra™) v Klininčnem centru v Ljubljani, na Kliničnem inštitutu za kemijo in biokemijo, 1425 bolnikom določili koncentracijo cTnI v krvi. Za statistično vrednotenje rezultatov smo preiskovano populacijo skrčili na 506 bolnikov, ki so bili pregledani na Internistični prvi pomoči. Pri analizi vzorcev smo ugotovili nasprotujoče si rezultate v 86 primerih, od katerih jih je bilo 18 diagnosticiranih za eno od oblik akutnega koronarnega dogodka (STEMI, NSTEMI, angina pektoris). Pridobljene podatke smo statistično obdelali in uporabili za oceno klinične zanesljivosti posamezne metode, pri čemer smo ugotovili, da je metoda DiaSorin Liaison® Troponin I bolj specifična, medtem ko je diagnostična občutljivost metode Bayer ADVIA Centaur® TnI-Ultra™ večja.

Keywords

ateroskleroza;ishemična bolezen srca;diagnostika;biokemični markerji;troponin I;

Data

Language: Slovenian
Year of publishing:
Source: Ljubljana
Typology: 2.11 - Undergraduate Thesis
Organization: UL FFA - Faculty of Pharmacy
Publisher: [B. Marčič]
UDC: 612
COBISS: 3179633 Link will open in a new window
Views: 1111
Downloads: 230
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Other data

Secondary language: English
Secondary title: Comparison of two chemiluminiscent methods for determination of troponin I in cardiovascular diseases
Secondary abstract: Cardiovascular diseases are the number one cause of death in Slovenia as well as globally. The most common cardiovascular diseases are caused by blockages in coronary arteries, mainly occuring in the process of atherosclerosis, called coronary heart diseases, of which acute myocardial infarction (AMI) is the most dangerous form. Suffering from AMI is increasing yearly. In order to prevent further complications following onset of AMI, quick and accurate diagnostiscs is necessary. In the past creatin kinase and creatin kinase isoenzyme (CK-MB) were the main biochemical markers of myocardial infarction. However in the year 2000 European Society od Cardiology and American College of Cardiology Task Force recommended cardiac troponin (cTnI and cTnT) as the biochemical marker of choice for diagnosis of myocardial infarction. In this study we measured cTnI concentration in 1425 patients with two different chemiluminiscent assays (DiaSorin Liaison® Troponin I and Bayer ADVIA Centaur® TnI-Ultra™). The analysis took place in Clinical Centre Ljubljana, Clinical Institute of Chemistry and Biochemistry. For statistical evaluation we used 506 patients who were examined in The Department of First Aid for Internal Medicine. Among these patients we found 86 cases, in which the two methods gave opposite results. Out of those 86 cases, 18 were diagnosed with either STEMI, NSTEMI or angina pectoris. We used these findigs to evaluate the specificity and sensitivity for both methods and came to the following conclusion: DiaSorin Liaison® Troponin I has higher specificity, while Bayer ADVIA Centaur® TnI-Ultra™ is more sensitive.
Type (COBISS): Undergraduate thesis
Pages: 60 f.
ID: 12053336