— 生理適應 · EASY · MCQ —
護理師評估一名胸痛病患，心電圖顯示 ST 波段上升。下列哪項檢驗結果對心肌梗塞具備最高特異性？
A nurse assesses a client with chest pain and observes ST-segment elevation on the ECG. Which laboratory test result is most specific to myocardial infarction?
- ACreatine kinase (CK)肌酸激酶 (CK)
- BTroponin I✓ 正解肌鈣蛋白 I (Troponin I)
- CLactate dehydrogenase (LDH)乳酸去氫酶 (LDH)
- DMyoglobin肌紅蛋白 (Myoglobin)
— Explanation · 中文詳解 —
心肌鈣蛋白（Troponin I 或 T）是目前診斷心肌梗塞的金標準，因其心肌損傷特異性極高且持續時間長。肌紅蛋白雖然出現最早，但缺乏特異性；CK 容易受骨骼肌損傷影響，LDH 則因非特異性已逐漸在臨床中被淘汰。
Cardiac troponin (I or T) is the gold-standard biomarker for diagnosing myocardial infarction because of its high specificity for cardiac tissue and prolonged elevation. Myoglobin rises early but lacks specificity. CK can be elevated from skeletal muscle injury, and LDH is non-specific and is no longer used for MI diagnosis.
✦ 台美臨床差異
美台臨床皆以 Troponin 為診斷核心，台方醫院通常會依賴急診檢驗室的快速免疫分析技術。