摘要
目的对免疫抑制法测定线粒体天门冬氨酸氨基转移酶(m-AST)的检测性能进行评价。探讨冠心病(CHD)患者和急性心肌梗死(AMI)患者血清天门冬氨酸氨基转移酶(AST)、m-AST、m-AST/AST比值的变化。方法对免疫抑制法测定m-AST的检测性能(精密度、正确度、线性范围、参考区间、最大稀释比)进行评估。选取行药物洗脱支架置入术的CHD患者和急诊行经皮冠状动脉介入治疗(PCI)术的AMI患者各44例,分别测定其术前、术后血清AST、m-AST等指标,计算m-AST/AST比值,并分析各项指标与Gensini积分的相关性。结果免疫抑制法检测m-AST的精密度、正确度、线性范围、参考区间均通过验证,符合临床要求,最大稀释比为1∶10。CHD患者PCI术后AST、m-AST水平及m-AST/AST比值与术前比较,差异均无统计学意义(P>0.05)。AMI患者PCI术后AST、m-AST、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶MB质量(CK-MB mass)、氨基末端B型钠尿肽原(NT-proBNP)水平显著高于术前(P<0.05),m-AST/AST比值显著低于术前(P<0.05)。CHD患者和AMI患者不同Gensini积分各组之间术后AST、m-AST水平及m-AST/AST比值与术前比较,差异均无统计学意义(P>0.05);且术前、术后AST、m-AST、m-AST/AST比值与Gensini积分均无相关性(P>0.05)。AMI患者术前、术后AST、m-AST水平和m-AST/AST比值均显著高于CHD患者(P<0.05),术前m-AST/AST比值差异无统计学意义(P>0.05)。结论血清AST、m-AST水平和m-AST/AST比值的变化与心肌细胞损伤程度有关,与动脉粥样硬化斑块发展进程无关,可反映AMI患者的心肌损伤情况及恢复情况。
Objective To evaluate the performance of immunosuppressive assay for mitochondrial aspartate aminotransferase(m-AST),and to investigate the changes of serum aspartate aminotransferase(AST),m-AST and m-AST/AST in patients with coronary heart disease(CHD)and acute myocardial infarction(AMI).Methods The determination performance(precision,accuracy,linear range,reference interval,maximum dilution ratio)of immunosuppressive assay for m-AST was evaluated.Totally,44 patients with CHD undergoing drug-eluting stent implantation and 44 emergency patients with AMI undergoing percutaneous coronary intervention(PCI)were enrolled.Preoperative and postoperative AST and m-AST levels were determined,the ratio of m-AST/AST was calculated,and their correlations with Gensini score were analyzed.Results The precision,accuracy,linear range and reference interval of immunosuppressive assay for m-AST were all verified,which met the clinical requirements,and the maximum dilution ratio was 1∶10.There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients before and after PCI(P>0.05).The levels of AST,m-AST,cardiac troponin T(cTnT),creatine kinase MB isoenzyme mass(CK-MB mass)and N-terminal B-type natriuretic peptide(NT-proBNP)in AMI patients after PCI were higher than those before PCI(P<0.05),and the m-AST/AST was lower than that before PCI(P<0.05).There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients and AMI patients with different Gensini scores before and after operation(P>0.05),and there was no correlation between AST,m-AST,m-AST/AST and Gensini score before and after operation(P>0.05).The levels of AST and m-AST before operation,as well as AST,m-AST and m-AST/AST after operation in AMI patients were higher than those in CHD patients(P<0.05),but there was no statistical significance in m-AST/AST before operation(P>0.05).Conclusions The changes of serum AST,m-AST and m-AST/AST are related to the degree of myocardial cell injury,but not to the development of atherosclerotic plaque,so they can reflect the myocardial injury and recovery of AMI patients.
作者
张茜林
沈逸枫
朱晶
张春燕
邵文琦
王蓓丽
郭玮
ZHANG Xilin;SHEN Yifeng;ZHU Jing;ZHANG Chunyan;SHAO Wenqi;WANG Beili;GUO Wei(Department of Clinical Laboratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Clinical Laboratory,Zhongshan Hospital,Fudan University(Xiamen Branch),Xiamen 361015,Fujian,China)
出处
《检验医学》
CAS
2021年第5期471-476,共6页
Laboratory Medicine
基金
国家自然科学基金面上项目(81772263)
国家自然科学基金面上项目(81972000)
国家自然科学基金青年项目(81902139)
2019厦门市医疗卫生重点项目(YDZX20193502000002)
2017年“上海青年临床医技人才(临床检验专业)培养资助计划”
复旦大学附属中山医院院内临床研究项目(2018ZSLC05)
上海市临床重点专科建设项目(医学检验科)。
作者简介
张茜林,女,1991年生,学士,技师,主要从事临床生化检验工作;通信作者:邵文琦,E-mail:shao.wenqi@zs-hospital.sh.cn。
