摘要
为探讨心脏特异性肌钙蛋白T（cTnT）在不稳定性心绞痛（UA）患者血清中检测的临床意义。应用酶联免疫法测定42例稳定性心绞痛（SA）患者和86例UA患者血清cTnT、肌酸磷酸激酶同功酶-MB（CK-MB）．并作对照分析。结果显示：SA患者血清cTnT无例升高（以cTnT＞0．2μg／L为界限值）；28例UA患者血消cTnT至少有1次升高．占32．6％，先均值为0．98±0．47μg／L，范围为0．20～1．86μg／L，这28例在入院后1周内有7例发生急性心肌梗塞（AMI），1例发生猝死；其余58例。cTnT不升高者中，在相同时间内，仅1例发生AMI，无猝死者。UA患者中cTnT阳性与阴性者的预后差别有统计意义（χ2=14．26，P＜0.001）。UA中CK－MB只有2例轻度升高，其中cTnT阳性与阴性各占1例。结果提示：①cTnT为较CK-MB更敏感、更特异的反应心肌损伤的指标；②UA中约有32．6％的患者血清cTnT异常升高，说明这部分患者已经发生心肌细胞损伤、心内膜下心肌梗塞或小灶性心肌梗塞，该类患者处于高危状态，极易发展成典型的AMI或猝死；③UA中cTnT不升高者，在很大程度上将有一个良好的预后。
The contents of serum cardiac specific troponin T (cTnT) and creatine kinase isoenzyme MB (CK-MB) aetivity were measured by enzyme immunoassay method in 42 patients with stable angina (SA ) and 86 patients with unstable angina (UA ) every four hours for 48 hours after admission to the hospital. The outcomes of interest during the hospitalization were acute myocardiol infarction (AMI) and sudden death. Results: cTnTn was detected (range, 0. 20~ 1. 86 μg per liter; mean 0. 98; median, 0. 17 ) in the serum of 28 of the 86 patients (32. 6 percent ) with UA.Only two of these patients had elevated CK-MB (one was positive for cTnT, the other was negative). of the 28 patients who were positive for cTnT, 7 cases had AMI and 1 case had sudden death within one week after admission. In contrast only one of the 58 patients with UA who were negative for cTnT developed AMI (P＜0.001),none had sudden death. cTnT was not detected in any of the 42 patients with SA, and none of these patients died in the same time. Conclusion: ①cTnT in serum appears to be a more sensitive and specifie indicator of mycardial cell injury than serum CK-MB; ② the elevating cTnT in serum of UA patient may probably indicate that the patient has already had a miero-infarction or none Q-infarction; ③ positive cTnT may be a prognostic indicator for unfavorable outcome to UA palients; ④ the patient who is negalive for cTnT may have a good outcome.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
1997年第1期15-17,共3页
Journal of Clinical Cardiology
关键词
冠心病
不稳定性
心绞痛
心肌
钙蛋白T
Unstable angina
Coronary heart disease
Cardiac specific troponin T
Creatine kinase isoenzyme MB
