2021-08-02每日一问：肌钙蛋白与心肌酶 201767

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.

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！？

Whatareyoutalkingabout？