一位 74 歲男性，因胸痛數次到醫院檢查，有關其檢驗報告
A 74-year-old male presented to the hospital with recurrent chest pain. Laboratory results revealed:
LDH1/LDH2 ratio > 1
CK-MB 460 U/L
Troponin I 15.0 ng/mL
K+ 3.0 mEq/L
Troponin I 15.0 ng/mL
Troponin I 是一種高度特異性的心肌細胞蛋白，當心肌細胞受損時，Troponin I 會釋放到血液中。
一般而言，Troponin I 的正常值小於 0.04 ng/mL。當 Troponin I 的值升高，特別是超過 0.4 ng/mL 時，通常表示心肌細胞已經受到損傷，常見於心肌梗塞。因此，患者的 Troponin I 為 15.0 ng/mL，遠高於正常值，明確指出其心肌細胞已經受到損傷。
Troponin I is a highly specific cardiac protein that is released into the bloodstream when heart muscle cells are damaged. A normal Troponin I level is typically less than 0.04 ng/mL. An elevated Troponin I level, especially above 0.4 ng/mL, is indicative of myocardial injury, often seen in myocardial infarction. The patient's Troponin I level of 15.0 ng/mL is significantly elevated, strongly suggesting myocardial damage.
LDH1/LDH2＞1
一般來說，LDH1/LDH2的比值正常情況下小於1，LDH 是乳酸脫氫酶，LDH1 和 LDH2 是其同工酶。
Generally, the normal ratio of LDH1 to LDH2 is less than 1. LDH stands for lactate dehydrogenase, and LDH1 and LDH2 are its isoenzymes.
雖然 LDH1/LDH2 比值升高常與心肌損傷相關，但並非特異性指標。其他疾病或組織損傷也可能導致該比值升高。此外，LDH 的半衰期較長，可能無法及時反映急性心肌損傷。
While an elevated LDH1/LDH2 ratio is often associated with myocardial injury, it is not a specific marker. Other diseases or tissue damage can also cause this ratio to increase. Additionally, LDH has a relatively long half-life, making it less sensitive for detecting acute myocardial injury.
CK-MB 460 U/L
CK-MB 的正常值範圍因實驗室而異，但一般來說，小於 5-25 U/L 被認為是正常的。
The normal range for CK-MB can vary between laboratories, but generally, it is considered normal if it is less than 5-25 U/L.
CK-MB 升高 通常表示心肌細胞受損，最常見的原因是急性心肌梗塞。CK-MB 的升高程度和變化趨勢，可以幫助醫生判斷心肌損傷的嚴重程度和發生時間。心肌梗塞是最常見的原因。當心臟的冠狀動脈阻塞，供血不足，心肌細胞就會壞死，釋放出大量的 CK-MB。
CK-MB elevation often indicates damage to heart muscle cells, and the most common cause is an acute heart attack. The extent and pattern of CK-MB elevation can help doctors determine the severity and timing of heart muscle damage. Heart attacks are the most common cause. When the coronary arteries of the heart become blocked, the heart muscle becomes deprived of oxygen and begins to die, releasing large amounts of CK-MB.
CK-MB 的變化是有時間性的，CK-MB 在心肌損傷後會迅速升高，達到高峰後逐漸下降，最終恢復正常。因此，醫生會在不同時間點多次抽血檢測，以追蹤 CK-MB 的變化趨勢。
CK-MB levels change over time. After heart muscle damage, CK-MB levels rise rapidly, peak, and then gradually decline back to normal. Therefore, doctors will draw blood for testing at different time points to track the changes in CK-MB levels.
CK-MB 並不是唯一的心肌損傷指標：Troponin I 是另一種更特異性的心肌損傷指標，通常比 CK-MB 更早升高，且持續時間更長。
CK-MB is not the only marker of heart muscle damage: Troponin I is another, more specific marker of heart muscle damage. It typically rises earlier and stays elevated longer than CK-MB.
K+ 3.0 mEq/dL
血清鉀離子的正常濃度為 3.5 - 5.0 mEq/L，故鉀離子濃度為 3.0 mEq/dL，屬於低鉀血症。
低鉀血症確實可能導致心律不整，但機制主要是引起ST段壓低和U波，而非心肌再極化時間延長。
The serum potassium level is 3.0 mEq/L, which is below the normal range of 3.5-5.0 mEq/L, indicating hypokalemia. While hypokalemia can indeed lead to arrhythmias, the primary mechanism is by causing ST segment depression and U waves, rather than prolonging myocardial repolarization time.
臨床意義Clinical Significance
患者的檢驗結果提示其可能發生了心肌梗塞。建議患者進一步進行心電圖、超音波等檢查，以確診病因並及時進行治療。
The patient's laboratory findings strongly suggest myocardial infarction. Further investigations, such as electrocardiography and echocardiography, are recommended to confirm the diagnosis and assess the extent of myocardial damage.
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