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Clin Chem：急诊高敏感性心肌肌钙蛋白检测与单血清试验的诊断准确性

2019-10-19 gladiator MedSci原创

比较诊断准确性
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本研究试图评估急诊<span lang="EN-US" style="font-size:12.0pt;mso-bidi-font-size:14.0pt;font-family:"Calibri","sans-serif"; mso-fareast-font-family:宋体;mso-bidi-font-family:"Times New R

本研究试图评估急诊(ED)高敏感性心肌肌钙蛋白I (hs-cTnI)检测急性冠脉综合征(ACS)的诊断准确性。该方法在低浓度下具有较高的精密度，能检测出96.8%的健康人体内的cTnI。

在后续的前瞻性多中心研究(“试验”和“验证”)中，我们纳入了疑似ACS的ED患者。在病人入院时，抽血测定hs-cTnI [Singulex Clarity®cTnI；第99百分位，8.67 ng/L;到达时的检测限(LoD)， 0.08 ng/L]。患者还接受了≥3小时的hs-cTnT (Roche Elecsys)检测。主要结局为确诊ACS，急性心肌梗死（AMI）或在30天内死亡或血运重建。

检测和验证研究分别纳入665和2470例人次，其中ACS分别为 94例(14.1%)和565例(22.9%)。在1.5 ng/L的范围内，hs-cTnI在两项研究中对急性心肌梗死都有良好的敏感性(分别为98.7%和98.1%)，可以“排除”40.1%和48.9%的患者。然而，ACS的敏感性较低（分别为95.7%和90.6%）。在0.8 ng/L的范围内，ACS的敏感性更高(97.5%和97.9%，排除了每个队列中28.6%的患者)。hs-cTnT检测在LoD上有相似的表现（24.6%被排除;97.2%的ACS敏感性）。

研究表明，hs-cTnI法可以立即排除40%的AMI患者和25%的ACS患者，其准确性与hs-cTnT在LoD上的准确性相当。由于hs-cTnI法在低浓度下具有较高的精密度，因此具有良好的临床应用价值。

原始出处：

Richard Body, Raphael Twerenbold,Diagnostic Accuracy of a High-Sensitivity Cardiac Troponin Assay with a Single Serum Test in the Emergency Department

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    2020-07-05 ms9833124466084992

    #诊断准确性#

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    2019-11-04 lilianxiang

    #准确性#

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    2020-03-19 daviiliu

    #高敏感性心肌肌钙蛋白#

    0

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    2019-10-21 ms5236388012055669

    #敏感性#

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    2019-10-21 wrj0124

    #心肌肌钙蛋白#

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在美国，经口机器人手术（TORS）和颈淋巴结清除术已经代替了放疗，并且是口咽鳞状细胞癌（OPSCC）的最常见治疗方法，然而，并没有随机试验来比较上述疗法的效果。最近，有研究人员评估了1年治疗后的生活质量（QOL）差异情况。研究包括了68名患者并随机分配到2个小组（每组34人），时间为2012年8月10号到2017年6月9号。放疗组平均的跟踪调查时间为25个月（IQR20-33），TORS加颈淋巴结

Clin Gastroenterol H：患有和没有炎症性肠病妇女怀孕所需时间的比较

由此可见，研究人员发现患有IBD的女性，尤其是那些接受过CD手术的女性，与没有IBD的女性相比，其怀孕的时间显著增加。这表明IBD女性的生育能力下降。

Eur Urol：转移肾细胞癌的一线肿瘤免疫联合疗法疗效分析

在转移性肾细胞癌（mRCC）中，近期的数据显示了一线药物易普利姆玛与纳武单抗（ipi-nivo）联合和免疫肿瘤(IO)/血管内皮生长因子(VEGF)抑制剂联合治疗的疗效情况。但是这些治疗策略之间的比较性数据仍旧有限。最近，有研究人员比较了ipi-nivo与IO-VEGF (IOVE)在mRCC中的疗效比较情况，并阐释了实践模式和二线疗法的疗效情况。研究总共有113名患者接受了IOVE联合疗法，75

Urol Oncol：机器人辅助根治性膀胱切除术与开放根治性膀胱切除术比较

机器人辅助根治性膀胱切除术（RARC）与开放根治性膀胱切除术（ORC）在中期/长期的比较性结果中还缺乏相关信息。最近，有研究人员比较了经历RARC或者ORC膀胱癌患者生存和肿瘤结果情况，且总的平均跟踪调查时间为5年。研究总共包括了481名患者，203名（42.2%）的患者经历了RARC，278名（57.8%）的患者经历了ORC。整个群体的平均跟踪调查时间为66个月。5年的无复发生存（RFS）在RA