摘要
目的 :观察急性冠脉综合征患者 (ACS)入院后血清中心肌肌钙蛋白Ⅰ (cTnI)的变化。探讨cTnI定量分析与冠脉综合征患者危险度分层的意义。方法 :10 3例ACS患者分别在入院、入院后 12h、2 4h采血。采用美国德普公司 (DPC)自动免疫化学发光分析仪及固相双位点化学发光试剂 (用IMMULITE系统 )测定cTnI、CK—MB浓度 ,根据CK—MB和ECG将患者分为不稳定型心绞痛 (UA)、Q波心肌梗死 (QMI)和非Q波心肌梗死 (NQMI) ,并分析cTnI、CK—MB与临床状况及心脏事件的关系。结果 :健康对照组、QMI、NQ MI和UAP患者血清cTnI分别为 0 2 0± 0 0 8ng/ml、32 84± 2 3 2 3ng/ml、9 4 9± 5 82ng/ml和 1 16±0 77ng/ml,与健康对照组比较均有显著统计学差异 (P <0 0 5 )。当cTnI、CK—MB分别取 2ng/ml、8ng/ml时 ,CK—MB对AMI诊断的敏感性和特异性均低于cTnI。CK—MB未升高的 6 0例UAP患者中有 2 7名cTnI≥ 0 4 0ng/ml(45 % ) ,在CK—MB升高的 13例NQMI患者中有 11例cTnI高 (84 6 2 % )。 10 3例ACS患者中 ,30d死亡 4例 (3 88% ) ,其中 70例血清cTnI≥ 0 4 0ng/ml的患者中死亡 4例 (5 7% ) ,cTnI <0 4 0ng/ml组无 1例死亡。CK—MB≥ 8ng/ml组 4 3例中有 2例死亡 (4 6 5 % ) ,CK—MB <8ng/ml组 6 0例中有 2例死亡 (3
Objective:The purpose of this study is to investigate the clinical signification of relationship between serum quantitative analysis troponin Ⅰ(cTnI) and the stratification of acute coronary syndrome(ACS)patients.Methods:Blood samples were obtained at admission,12,24 hours later from 103 patients with ACS.Serum concentrations of cTnI and CK-MB were simultaneously measured using the solid-phase two-site chemiluminescent immunometric assay by IMMULITE systems.According to CK-MB and ECG,We divided all the patient into three subgroups,unstable angina(UA)?Q wave myocardiac infarction (QMI)?and none Q wave myocardiac infarction (NQMI),So we could analyse the relations between the changes of cTnI and clinical conditions,the characteristics of coronary lesion and the cardiac events,including AMI,sudden death and refractory angina pectoris.Results:The serum cTnI value was 0.20±0.08ng/ml,32.84±23.23ng/ml,9.49±5.82ng/ml and l.16 ±0.77ng/ml in the health control,QMIgroup NQMIgroup and UA group defined at (P<0.05) respectively.When the cutoff of cTnI and CK-MB were 2.0 ng/ml and8.0ng/ml,The sensitivity and specificity were inferior to cTnI in diagnosing AMI.In the UA group(n=60) which CK-MB was not high enough,there was 27 patients with cTnI ≥0.4ng/ml,while in the NQMI group(n=13) there was 11 patients with high cTnI.Among all 103 patients with ACS,4 died within 30days,which were all in cTnI ≥0.4ng/ml group.With the progressive increase of cTnI,the cardiac events also increase;which would be related to the quantity of myocardiac necrosis.So cTnI had higher negative predictive values.Conclusion:Quantitative measurement of serum cTnI would the good marker to the stratifiction of patients with ACS and would be of improtant prognostic values.
出处
《内蒙古医学杂志》
2002年第5期381-384,共4页
Inner Mongolia Medical Journal
