CAJ | 학술논문

探讨心肌肌钙蛋白（cardiac troponin I，cTnI）、心脏型脂肪酸结合蛋白（heart fatty acid－binding Pro-tein，H－FABP）和C反应蛋白（C－reactive protein，CRP）作为标志物在临床前毒理实验中诊断早期心肌损伤的应用价值。雄性SD大鼠单次腹腔注射给予异丙肾上腺素0．5、5、50 mg／kg，于给药后1、3、6、12、24 h采血及解剖。采用液态悬浮芯片系统Luminex测定血清cTnI，ELISA法测定H－FABP与CRP水平，全自动生化分析仪测定血清谷草转氨酶（AST）和肌酸激酶同工酶（CK－MB）活力，观察大鼠心脏组织病理学改变。通过ROC曲线比较给药后1～24 h各标志物的灵敏度与特异性。cTnI 在3～24 h内给药组与对照组相比有不同程度的升高；H－FABP在1～3 h时给药组明显高于对照组，早于可见病理损伤出现的时间；CRP在24 h时中、高剂量组略有升高。大鼠血清中cTnI、H－FABP、CRP、AST、CK－MB的ROC曲线下面积AUC分别为：0．821、0．763、0．584、0．741、0．742。在本心肌损伤模型中，cTnI和H－FABP诊断效能可能高于传统心肌酶谱，而C RP未表现出对早期心肌损伤的诊断价值。
탐토심기기개단백（cardiac troponin I，cTnI）、심장형지방산결합단백（heart fatty acid－binding Pro-tein，H－FABP）화C반응단백（C－reactive protein，CRP）작위표지물재림상전독리실험중진단조기심기손상적응용개치。웅성SD대서단차복강주사급여이병신상선소0．5、5、50 mg／kg，우급약후1、3、6、12、24 h채혈급해부。채용액태현부심편계통Luminex측정혈청cTnI，ELISA법측정H－FABP여CRP수평，전자동생화분석의측정혈청곡초전안매（AST）화기산격매동공매（CK－MB）활력，관찰대서심장조직병이학개변。통과ROC곡선비교급약후1～24 h각표지물적령민도여특이성。cTnI 재3～24 h내급약조여대조조상비유불동정도적승고；H－FABP재1～3 h시급약조명현고우대조조，조우가견병리손상출현적시간；CRP재24 h시중、고제량조략유승고。대서혈청중cTnI、H－FABP、CRP、AST、CK－MB적ROC곡선하면적AUC분별위：0．821、0．763、0．584、0．741、0．742。재본심기손상모형중，cTnI화H－FABP진단효능가능고우전통심기매보，이C RP미표현출대조기심기손상적진단개치。
This study is focused on the application value of taking cardiac troponin I(cTnI),Heart Fatty Acid-binding Protein(H-FABP)and C-reactive protein(CRP)which used as the biomarkers to diagnose preclinical cardiac injury.Male SD rats were trea-ted a single i.p.injection of isoprenaline at levels of 0.5,5 or 50 mg/kg,and were evaluated at 1,3,6,12,24 h post-dosing for testing biomarkers and cardiac histology.Cardiac troponin I(cTnI)levels was measured by luminex,Heart fatty acid-binding protein (H-FABP)and C-reactive protein(CRP)were measured by enzyme-linked immunosorbent assay(ELISA).The activities of glu-tamic-oxalacetic transaminase(AST)and creatine kinase MB(CK-MB)were determined by automatic biochemical analyzer.Rat cardiac histopathology were examined under microscope.Receiver operator characteristics (ROC)analysis was used to compare sensi-tivity and specificity of each biomakers.The mean levels of cTnI were significant elevated at 3 to 24 h in isoprenaline group.The H-FABP levels of serum were greater than that of controls at 1 to 3 h,earlier than visible cardiac injuries observed.CRP was increased at 24 h in isoprena group.In ROC analysis,the area under the curve of cTnI,H-FABP,CRP,AST and CK-MB were 0.821,0.763, 0.584,0.741,0.742,respectively.In this model,the diagnostic value of cTnI and H-FABP are higher than other classical indica-tors,while CRP showing no diagnostic value to the early cardiac injury.