Serum Troponin I (TnI) and Troponin T (TnT)
Troponin is a regulatory protein of muscle contraction and consists of three structurally distinct subunits, troponin T (TnT), troponin I (TnI) and troponin C (TnC). Troponin relaxes actomy, allowing actomyosin to interact with sarcoplasmic globulin, causing muscle contraction. The structure of T and I subunits in myocardium is different from other muscle tissues. Myocardial troponin T and I (CTnT, CTnI) have a rapid increase in blood concentration after onset due to small molecular weight. Basic Information Specialist classification: cardiovascular examination classification: biochemical examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Normal value: no Above normal: negative: Negative only appeared in the control zone with a ribbon. Positive: Positive bands appeared in both the test area and the control area. Tips: Before the examination, the diet is light and alcohol is prohibited. Check for an empty stomach in the morning. Normal value 1, rapid detection of cardiac troponin T, I Positive: ribbons appeared in both the test and control areas. Negative: only the ribbon appeared in the control area. Invalid: no ribbon appears in both the test area and the control area. 2. Determination of cardiac troponin T by ELISA <0.1 μg/L. Clinical significance 1, acute myocardial infarction (AMI), blood concentration increased rapidly after onset, GTnT, CTnI, 3 ~ 6h exceeded the upper limit of the reference value, GTnT peaked at 10 ~ 24h, 10 to 15 days returned to normal. CTnI peaked at 14 to 20 hours and returned to normal within 5 to 7 days. That is, it appears early, and is similar to or earlier than CK-MB; it disappears slowly, lasts longer than LD1, and the window period of diagnosis is particularly long, which has the advantages of CK-MB and LD1. Sensitivity GTnT is 50% to 59% (0 to 6h), CTnI is 6% to 44%, specific GTnT is 74% to 96%, and CTnI is 93% to 99%. GTnT is reported to be more sensitive than CK-MB in the diagnosis of AMI, but GTnT has been reported in blood samples from patients with kidney disease, so the specificity is poor. GTnT is more sensitive than LD1/LD2 in diagnosing AMI, and CTnI is not found in the blood of patients with kidney disease and other diseases, so CTnI is the only specific marker for heart damage. Because GTnT and CTnI disappear slowly, it can be used as a marker for late myocardial infarction. 2, GTnT and CTnI can be used as indicators of myocardial infarction symptoms in cardiac surgery. When patients undergo arterial bypass surgery, if GTnT and CTnI levels increase, it indicates myocardial infarction, and there is no change in CK-MB content. High results may be diseases: precautions for acute myocardial infarction 1. Rapid detection of cardiac troponin T and I: (1) The test strip can only be used once, and repeated use is invalid. (2) There is no ribbon in the test strip and the control zone of the test strip. If the test strip is repeated and no result is obtained, the test strip is invalid. (3) Immunochromatography The CTnT and CTnI are suitable for bedside rapid test, but only qualitative or semi-quantitative. It is necessary to quantitatively determine the severity of the disease and the choice of treatment. 2. Determination of cardiac troponin T by ELISA: (1) CTnT specimens are best used with serum, do not use anticoagulated plasma, because anticoagulants such as: heparin, EDTA, etc. have an effect on CTnT. (2) Since CTnT is released from myocardial cell damage, try to avoid hemolysis of the specimen. If the specimen is hemolyzed, the detection result may be increased. (3) Prepare the incubation solution without cryopreservation, and store it at 2~8 °C. (4) Before the experiment, it should be noted that the reagent has no failure, such as deterioration, and its color is deepened. (5) In order to improve the reliability of CTnT detection, attention should be paid to the accuracy of the sample loading and other operations. The colorimetric color is preferably double wavelength. Inspection process 1. Rapid detection of cardiac troponin T and I: (1) Open the wrapper and mark the sample number. (2) Add 5-6 drops of serum sample to the sample tank. (3) Observe the appearance of the ribbon within 10 to 15 minutes. 2. Determination of cardiac troponin T by ELISA: (1) Standard serum was added to the coated plates, and the control serum and the patient samples were each in the corresponding wells of 50 μl. (2) Add 50 μl of incubation buffer to each well and mix gently. (3) After 60 minutes incubation at room temperature, wash three times and complete within 10 minutes. Dip the micropores firmly on the absorbent paper. To remove residual water droplets. (4) Add 100 μl of the enzyme conjugate to each well and mix gently. (5) Empty the incubation solution in the microplate, wash the micropores three times with the washing solution, and vigorously tap the micropores on the absorbent paper to remove residual water droplets. (6) Add 200 μl of the original substrate solution to the corresponding wells, avoid the light, mix gently, and let stand for 30 min. (7) The absorbance value (OD value) was measured at 405 nm and 630 nm in two wavelengths using a microplate reader. Not suitable for the crowd no. Adverse reactions and risks no.
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