Quantitative analysis of troponin I serum values in patients with acute cholecystitis [Kvantitativna analiza serumskog troponina i u bolesnika s akutnom upalom žučnjaka]

Babić, Žarko and Bogdanović, Zoran and Dorosulić, Zdravko and Basha, Merita and Krznarić, Željko and Sjekavica, Ivo and Kujundžić, Milan and Tadić, Mario and Banić, Marko and Jagić, Vjekoslav and Marušić, Marinko (2012) Quantitative analysis of troponin I serum values in patients with acute cholecystitis [Kvantitativna analiza serumskog troponina i u bolesnika s akutnom upalom žučnjaka]. Collegium Antropologicum, 36 (1). pp. 145-150. ISSN 0350-6134

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Abstract

The diagnosis and staging of acute cholecystitis, upon a lot of diagnostic methods and some scoring systems, is still a great clinical problem. The aim of the study was to investigate if serum Troponin I is elevated in patients with acute cholecystitis. Following informed consent, 65 patients with clinical and laboratory signs of acute cholecystitis were enrolled. All patients had measured serum Troponin I level and an abdominal ultrasound was done before definitive treatment was performed. Increased serum Troponin I level was found in most patients with severe form of acute cholecystitis (p < 0.00001). It reached sensitivity of 94.5% and specificity of 57.1% of this test. In multiple regression analysis Troponin I significantly correlated (p < 0.05) with the serum aspartate aminotransferase (r = 0.27), gamma-glutamyl transferase (r = 0.25) and gallbladder wall (> 6 mm) thickness (r = 0.58). Our study confirms that in most patients with severe and acute cholecystitis, serum Troponin I is increased. Troponin I level is in a lower range than it would be in patients with cardiac muscle damage or necrosis. Measuring serum Troponin I is a fast, reliable and widely performed test that could, with other routinely measured parameters, help in early diagnosis of the severe form of acute cholecystitis.

Abstract in Croatian

Dijagnozu i stupnjevanje akutne upale žučnjaka i dalje je, unatoč brojnim dijagnostičkim metodama, ostao težak zadatak. Cilj ovog rada bio je istražiti ulogu povišenih serumskih vrijednosti Troponina I u bolesnika s akutnim kolecistitisom. Nakon informiranog pristanka u studiju smo uključili 65 bolesnika s kliničkim i laboratorijskim znakovima akutne upale žučnjaka. Svim bolesnicima je mjerena razina serumskog Troponina I te im je učinjen i transabdominalni ultrazvuk prije početka liječenja. U većine bolesnika s teškim oblikom akute upale žučnjaka nađene su povišene vrijednosti Troponina I (p<0,00001). Postigli smo osjetljivost testa od 94,5% i specifičnost testa od 57,1%. Testom multiple regresije statistički značajnija korelacija (p<0,05) postignuta je za Troponin I, za serumsku aspart aminotransferazu (r=0,27), gamaglutamil transferazu (r=0,25) i za debljinu stjenke žučnjaka (>6 mm) (r=0,58). Naša studija potvrđuje da je većina bolesnika s teškim oblikom akutne upale žučnjaka imala povišene vrijednosti Troponina, ali u vrijednostima koje nisu karakteristične za oštećenje ili nekrozu srčanog mišića. Mjerenje Troponina I brza je i široko primjenjiva metoda koja uz ostale rutinske parametre može pomoći u dijagnostici i stupnjevanju teških oblika akutne upale žučnjaka.

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