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肌钙蛋白T检测对不稳定性心绞痛患者的预后判断 |
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The prognostic value of serum troponin T in unstable angina pectoris
吴学思 陈韵岱 石镜 蔺洁
Wu Xuesi, Chen Yundai, Shi Jing, et al
【摘要】 目的 本研究旨在评价血清肌钙蛋白T(cTnT)定量测定对不稳定性心绞痛患者
的预后判断价值。方法 对60例不稳定性心绞痛患者(UAP)、18例稳定心绞痛患者及20例
健康人分别进行血清cTnT、肌酸激酶(CK)和其同工酶(CK-MB)的测定，并观察住院期间的
心性事件发生率。结果 60例UAP患者中32例(53%) cTnT≥0.3μg/L，明显高于余28例(分
别为0.75±0.24μg/L和0.12±0.04μg/L，P＜0.001)，但CK、CK-MB差异并无显著性。不稳
定心绞痛患者中cTnT升高组30天内其发生急性心肌梗塞、心脏性猝死、顽固性心绞痛的发
生率明显高于cTnT正常值(43.8%比7.1%，P＜0.01)；对上述心脏事件，定量cTnT检测的敏
感性为87.5%，阴性预期值达92.9%，准确性为66.7%。结论 cTnT是反映心肌细胞损伤的灵
敏性、特异性均较好的生化指标；cTnT升高对判断不稳定心绞痛患者预后有较好的预测价值。
【关键词】 肌钙蛋白 冠状动脉疾病 心绞痛，不稳定性 预后
The prognostic value of serum troponin T in unstable angina pectoris Wu Xuesi, Chen Yundai,
Shi Jing, et al. Beijing Anzhen Hospital, Capital Medical University, Beijing 100029
【Abstract】 Objective To evaluate the prognostic value of serum cardiac troponin T (cTnT) in
unstable angina pectoris (UAP).Methods Serum cTnT, creatine kinase (CK) and isoenzyme MB
(CK-MB) were simultaneously measured in 20 healthy subjects, 18 stable angina pectoris (SAP) and
60 UAP patients. The diagnosis was based on the WHO criteria, and AMI was ruled out. ELISA was
carried out to detect cTnT quantitatively. cTnT≥0.3ng/ml was considered as evidence of myocardial
damage.Results Among 53% of the UAP patients (group B, 32 cases) cTnT levels were increased,
while the rest (group A, 28 cases) remained normal (0.75±0.24 vs 0.12±0.04 ng/ml,respectively, P＜0.01).
cTnT value in the healthy subjects and SAP patients were 0.02±0.06 and 0.03±0.05ng/ml, respectivey. No
significant difference was found in serum CK and CK-MB among all the groups. Among the 60 UAP
patients, the incidences of cardiac events, including AMI, sudden cardiac death and refractory angina
pectoris with in 30 days, were [1] [2] [3] 下一页
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