• 游客
收藏 | 举报 2017-06-07 13:42   关注:316   回答:3

每日一问:肌钙蛋白与心肌酶 2017-6-7...

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每日一问:肌钙蛋白与心肌酶 2017-6-7

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  • 游客
举报 2017-06-17 13:33

Incorrect.

THE CORRECT ANSWER IS:

The patient has not suffered an acute myocardial infarction and a sample mix-up has occurred.

A sample mix-up occurred in the 2-h post-admission samples. An AMI is unlikely given these test results because increases in plasma cTnI and CK-MB occur concurrently and cTnI concentrations remain elevated for days following an AMI. A heterophile antibody would cause consistently abnormal results rather than sporadic elevations in some samples but not others. Consistently normal CK-MB results in conjunction with normal cTnI results at admission and 6 h post admission strongly suggest that the 2-h post-admission cTnI sample was a mislabeled specimen obtained from a different patient.
Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Fundamentals of Clinical Chemistry, 6th ed. St. Louis, MO: Saunders Elsevier, 2008:625.


  • 游客
举报 2017-06-08 17:03

我选的A。我认为(蒙)2小时升高是发生了小面积的梗死,所以6小时的时候又正常了。

但答案说是标本搞混了!可这CK-MB也太巧了吧,两个病人的居然完全一样,这不科学。

关键是我们不做肌钙蛋白,不知道1.6到底是怎样的一个水平。

假设这是一个真实案例,临床医生一看到2小时的报告,再结合胸痛,岂不是立马就会诊断为AMI,进行治疗吗!?

  • 游客
举报 2017-06-10 18:03
What are you talking about?