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cTnT 在判断急性心肌梗死及不稳定型心绞痛预后中的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第1期
页码:
55-57,60
栏目:
论著
出版日期:
2002-01-01

文章信息/Info

Title:
The diagnosing value of cardiac troponin T in acute myocardia linfarction and the prognos is of unstable angina pectoris
作者:
柴小奇;  王心方;  党　群;  王　敬;  吴先军;  张　莹
汉中市中心医院心内科, 陕西 汉中 723000
Author(s):
CHAI Xiao-qi; WANG Xin-fang ; DANG Qun; WANG Jing ; WU Xian-jun;  ZHANG Ying
Hanzhong Center Hospital,Hanzhong, Shaanxi 723000, China
关键词:
肌钙蛋白T;  心肌梗塞;  急性;  心绞痛;  不稳定型;  诊断;  预后
Keywords:
tropnin T;  acute myocardial infarction;  angina pectris;  unstable;  diagnosis;  prognosis
分类号:
R541.4; R540.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨心肌肌钙蛋白T(cTnT) 对急性心肌梗死(AMI) 诊断及评估不稳定型心绞痛(UAP) 预后的临床价值。方法 对76例胸痛患者进行入院即刻血浆cTnT 半定量、同步心肌酶学定量测定, 观察对比cTnT与心肌酶学在诊断AM及评估UAP患者预后中的特异性和敏感性。结果 76例胸痛患者中AMI 34例、UAP 27例、稳定劳力性心绞痛8例、其它胸痛疾患7例。AMI 34例cTnT全部阳性, 而UAP 23例和其余病例cTnT 均为阴性。AMI 患者同步CK,A ST 升高者28 例,LDH 升高者30 例。cTnT 与心肌酶学差异未达显著水平(P > 0. 05) ,但发病2～ 5 h者10 例, 心肌酶各项均正常, 与cTnT对比有高度显著性差异(P<0.01) ; 发病5～11d 者6 例, 仅2例LDH 还表现出升高外, 其余心肌酶均正常, 与cTnT 对比有显著性差异(P<0.05) ; 发病5～120h 者相差均不显著(P>0.05)。在27 例UAP患者中, cTnT 阳性组AMI和难治性心绞痛发生率显著高于cTnT阴性组(P<0.01);cTnT 阴性组药物疗效好, 近期心脏事件发生率低, 与cTnT阳性组对比亦有高度显著性差异(P<0.01)。结论cTnT是反映心肌细胞损伤灵敏性、特异性均较好的生化指标;cTnT对诊断早期和晚期AMI的价值高于心肌酶学;cTnT阳性的UAP患者近期心脏事件发生率高, 预后差。
Abstract:
AIM To evaluate the value of cardiac troponin T ( cTnT ) in diagnosing acute myocardial infarction (AMI) and the prognosis of unstable angina pectoris (UAP). METHODS Plasma cTnT and cardiac enzyme were measured simultaneously in 76 chestache patients. The sensitivity in diagnosising AMI and evaluating the prognosis of UAP patients was observed.RESULTS 34 of the 76 chestache patients were with AMI, 27 with UAP, 8 with stable angina pectoris, and 7 were with other diseases. The cTnT of the 34AMI patients was positive and those of the 23 UAP patients and other patients were negative. Of the AMI patients 28 suffered elevated CK and AST , and 30 suffered elevated LDH. No significant difference was found in cTnT and cardiac enzyme (P > 0. 05). Ten patients with chestache of 2～ 5 h duration showed normal cardiac enzymes,wich was highly statistic difference in contrast with cTnT (P < 0. 01).Of the 6 cases with chestache of 5～ 11 days duration, only 2 cases suffered elevated LDH and others showed normal cardiac enzymes. There was a marked statistic difference in contrast with cTnT (P < 0. 05) ; There was no statistic difference among the patients with chestacke of 5～ 120 h duration in contrast with cTnT (P > 0. 05) ; Among 27 UAP patients, the incidence of AMI and refractory in the positive cTnT groups is significantly higher than that in the negative cTnT group (P < 0. 01). The incidence of cardiac events in the negative cTnT group is significantly lower than that in the positive cTnT group (P < 0. 01). CONCLUSION cTnT level demonstrates minor myocardial damage. The value of cTnT in diagnosising earlier and lately AMI is higher than that of cardiac enzyme; The incidnece of cardiac events in UAP patients with positive cTnT is high.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-04-03.
更新日期/Last Update: 2002-01-01