laboratory diagnosis of myocardial infarction：心肌梗死的实验室诊断

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1、LABORATORYEVALUATIONOFTHEROSCLEROSISANDACUTECORONARYSYNDROMER.MohammadiBiochemist(Ph.D.)FacultymemberofMedicalFacultyCORONARYHEARTDISEASECORONARYARTERYOBSTRUCTIONMAINCOMPONENTSOFVASCULARWALLINTIMALTHICKENINGMAJORCOMPONENETSOFATHEROMATOUSPLAQUEPATHOGENESISOFAT

2、HERSCLEROSISCELLULAREVENTS&CELLULARINTERACTIONSRISKFACTORSFORCHDClinicalRiskFactorsLaboratoryRiskFactorsCLINICALRISKFACTORSLABORATORYRISKFACTORSCommonLipidMarkersIncludingTC,HDL-C,LDL-C&TGUncommonLipidMarkersIncludingLp(a),beta-VLDL,ApoA-I&ApoB-100NonlipidMark

3、ersIncludingHomocysteine&hsCRPSOURCESOFRESULTVARIABILITYINLIPIDMEASURMENTAnalyticalErrorPhysiologicVariationFastingDiseasesDrugsPostureVenousvs.CapilarySamplesPlasmavs.SerumStorageANALYTICALERROR%TotalError=%Bias+1.96(%CV)BIOLOGICALVARIATIONSDuetoAge,Gender,Die

4、t,SeasonFASTINGFastingforatLeast9HoursIsNecessaryforTGFastingIsNotNecessaryforTCSlightDecreaseofLDL-C&HDL-CAfterEatingDIEASESMyocardialInfarctionShockTraumaSurgeryWeightloseFeverThyroidDiseaseLiverDiseaseKidneyDiseaseDRUGSOralContraceptiveIncreasesVLDLAnabolics

5、teroidsIncreaseVLDL&DecreaseHDLPOSTURE&OCCLUSIONTG,TC&LipoproteinsIncreaseinStandingPositionProlongedVenousOcclusionHasSimilarEffectVenousvs.CapilaryMeasurementsinCapilaryBloodSampleSeemtoBeaLittleLowerThanVenousSamplePLASMAvsSERUMSerum&PlasmaCanbeUsedPlasmaIsP

6、referredforElectrophoresis&UltracentrifugationEDTAIsPreferred,ButtheResultsAreLowerHeparinCanAlsoBeUsedProteinAggregationOccursInPlasmaSTORAGEItIsRecommendedtoAnalyzeatDayofSampleCollectionSamplesCanBeStoredinRefrigeratororFreezerANALYTICALAPPROACHINLIPIDSABNO

7、RMALITIES1)LIPIDSDETERMINATIONS2)LIPOPROTEINANALYSISLIPIDSDETERMINATIONCholesterolsTriglyceridesPhospholipidsFreeFattyAcids(FFAs)TotalSerumLipidsCHOLESTEROLDETERMINATIOMChemicalLiberman-BurchardSchoenheimer-SperryAbell-KendalCHOLESTEROLDETERMINATIOMEnzymaticCho

8、lesterylEsterCholesterol+FFACholesterol+O2OixidizedCholesterol+H2O2H2O2+ChromogenColoredComplex+H2OChoesterylEsteraseChoesterolOxidasePeroxidaseCHOLESTEROLDETERMINATIOMSampl