Abstract：
Cardiac troponins T and I are the main (most sensitive and specific) laboratory indicators of myocardial cell damage. A combination of laboratory signs of myocardial cell damage (elevated levels of cardiac troponins T and I) with clinical (severe chest pain spreading to the left side of the human body) and functional (rise or depression of the ST segment, negative T wave or emergence of the Q wave according to electrocardiography and/or decrease in the contractility of myocardial areas exposed to ischemia according to echocardiography) signs of myocardial ischemia is indicative of the ischemic damage to cardiomyocytes, which is characteristic of the development of acute coronary syndrome (ACS). Today, with early diagnostic algorithms for ACS, doctors rely on the threshold levels of cardiac troponins (99th percentile) and on the dynamic changes in the serum levels over several hours (one, two, or three) from the moment of admission to the emergency department. That said, some recently approved highly sensitive methods for determining troponins T and I show variations in 99th percentile reference levels, depending on gender. To date, there are conflicting data on the role of gender specificities in the serum levels of cardiac troponins T and I in the diagnostics of ACS, and the specific mechanisms for the formation of gender differences in the serum levels of cardiac troponins T and I are unknown. The purpose of this article is to analyze the role of gender specificities in cardiac troponins T and I in the diagnostics of ACS, and to suggest the most likely mechanisms for the formation of differences in the serum levels of cardiac troponins in men and women.
摘要：
心肌肌钙蛋白T和I是心肌细胞损伤的主要(最敏感和特异性)实验室指标。心肌细胞损伤的实验室体征（心肌肌钙蛋白T和I水平升高）与临床（严重的胸痛扩散到人体左侧）和功能（ST段上升或下降，根据心电图的负T波或Q波的出现和/或根据超声心动图暴露于缺血的心肌区域的收缩性降低）心肌缺血的迹象表明对心肌细胞的缺血性损伤，这是急性冠状动脉综合征（ACS）发展的特征。今天,使用ACS的早期诊断算法，医生依赖于心肌肌钙蛋白的阈值水平(第99百分位数)和几个小时内血清水平的动态变化(一个，两个,或三）从进入急诊室的那一刻起。那就是说,一些最近批准的测定肌钙蛋白T和I的高度敏感方法显示第99百分位参考水平的变化，取决于性别。迄今为止,关于血清肌钙蛋白T和I水平的性别特异性在ACS诊断中的作用存在矛盾的数据，血清肌钙蛋白T和I水平性别差异形成的具体机制尚不清楚。本文的目的是分析心脏肌钙蛋白T和I的性别特异性在ACS诊断中的作用。并提出男性和女性血清肌钙蛋白水平差异形成的最可能机制。
