循環器ジャーナル70巻4号

2022年10月発行

特集 循環器救急診療・集中治療を極める Ⅴ．救急集中治療に必須の検査をマスターする

心血管バイオマーカー

著者： 白壁章宏¹ 浅井邦也¹

所属機関： ¹日本医科大学千葉北総病院集中治療室

ページ範囲：P.560 - P.565

Point
・急性心不全における心筋ストレスバイオマーカーとして，BNPとNT-proBNPが挙げられる．それぞれの特性を考慮し，日常診療に当たるべきである．
・高感度トロポニンTは，非ST上昇型急性心筋梗塞の診断補助に特に有用である．しかし，他の循環器疾患でも上昇することが知られており，特に急性心不全の診療の際などは，その他の臨床理学所見と合わせて緊急冠動脈造影検査の適応を判断すべきである．
・急性心不全における潜在性心筋障害マーカーとして，H-FABPが挙げられる．急性腎障害と関連して上昇することや，長期予後不良と関連することが報告されており，さらに様々な急性期循環器疾患での予後予測に有用である．
・D-ダイマー（D-dimer）は，急性大動脈解離や急性血栓塞栓症の診断または除外のためのバイオマーカーとして古くから知られている．

参考文献

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