中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2009年
1期
32-33,35
,共3页
肌钙蛋白Ⅰ%心绞痛%不稳定型%危险性分层
肌鈣蛋白Ⅰ%心絞痛%不穩定型%危險性分層
기개단백Ⅰ%심교통%불은정형%위험성분층
Troponin Ⅰ%Angina,unstable%Risk stratification
目的 探讨心脏肌钙蛋白Ⅰ(cTnI)对老年不稳定型心绞痛(UAP)患者危险分层的价值.方法 对72例老年UAP患者、27例稳定型心绞痛(SAP)患者及22例健康对照者分别进行血清cTnI测定,并观察住院1个月内心脏事件发生情况.结果 UAP组血清cTnI值为(1.96±0.61)μg/L,明显高于SAP组的(0.68±0.19)μg/L及对照组的(0.46±0.10)μg/L(P均＜0.01).UAP组内,随着Braunwald临床分级增高,Ⅰ～Ⅲ级血清cTnI值相应增高[分别为(1.25±0.38)μg/L、(2.12±0.34)μg/L及(3.06±0.72)μg/L](P＜0.05).对照组、SAP组及Braunwald Ⅰ级UAP患者无一例发生心脏事件;18例Ⅱ级患者中,1例(其血清cTnI≥1.5μg/L)发生非致命性心肌梗死(MI);33例Ⅲ级UAP患者中,21例血清cTnI≥1.5μg/L患者中的9例发生心脏事件(6例非致命性心肌梗死、3例心脏猝死),总心脏事件发生率16.7%;16例血清cTnI＜1.5μg/L者仅1例发生非致命性MI,其总心脏事件发生率6.3%.血清cTnI≥1.5μg/L者心脏事件发生率明显高于cTnI＜1.5μg/L者(P＜0.05),比数比(OR)为2.05(16.7%/6.3%).95%可信限为1.02～9.78.血清cTnI≥1.5μg/L时判断心脏事件的阳性预测值为44.3%,阴性预测值为84.8%.结论 血清cTnI检测对老年UAP患者危险分层有一定的临床价值.
目的 探討心髒肌鈣蛋白Ⅰ(cTnI)對老年不穩定型心絞痛(UAP)患者危險分層的價值.方法 對72例老年UAP患者、27例穩定型心絞痛(SAP)患者及22例健康對照者分彆進行血清cTnI測定,併觀察住院1箇月內心髒事件髮生情況.結果 UAP組血清cTnI值為(1.96±0.61)μg/L,明顯高于SAP組的(0.68±0.19)μg/L及對照組的(0.46±0.10)μg/L(P均＜0.01).UAP組內,隨著Braunwald臨床分級增高,Ⅰ～Ⅲ級血清cTnI值相應增高[分彆為(1.25±0.38)μg/L、(2.12±0.34)μg/L及(3.06±0.72)μg/L](P＜0.05).對照組、SAP組及Braunwald Ⅰ級UAP患者無一例髮生心髒事件;18例Ⅱ級患者中,1例(其血清cTnI≥1.5μg/L)髮生非緻命性心肌梗死(MI);33例Ⅲ級UAP患者中,21例血清cTnI≥1.5μg/L患者中的9例髮生心髒事件(6例非緻命性心肌梗死、3例心髒猝死),總心髒事件髮生率16.7%;16例血清cTnI＜1.5μg/L者僅1例髮生非緻命性MI,其總心髒事件髮生率6.3%.血清cTnI≥1.5μg/L者心髒事件髮生率明顯高于cTnI＜1.5μg/L者(P＜0.05),比數比(OR)為2.05(16.7%/6.3%).95%可信限為1.02～9.78.血清cTnI≥1.5μg/L時判斷心髒事件的暘性預測值為44.3%,陰性預測值為84.8%.結論 血清cTnI檢測對老年UAP患者危險分層有一定的臨床價值.
목적 탐토심장기개단백Ⅰ(cTnI)대노년불은정형심교통(UAP)환자위험분층적개치.방법 대72례노년UAP환자、27례은정형심교통(SAP)환자급22례건강대조자분별진행혈청cTnI측정,병관찰주원1개월내심장사건발생정황.결과 UAP조혈청cTnI치위(1.96±0.61)μg/L,명현고우SAP조적(0.68±0.19)μg/L급대조조적(0.46±0.10)μg/L(P균＜0.01).UAP조내,수착Braunwald림상분급증고,Ⅰ～Ⅲ급혈청cTnI치상응증고[분별위(1.25±0.38)μg/L、(2.12±0.34)μg/L급(3.06±0.72)μg/L](P＜0.05).대조조、SAP조급Braunwald Ⅰ급UAP환자무일례발생심장사건;18례Ⅱ급환자중,1례(기혈청cTnI≥1.5μg/L)발생비치명성심기경사(MI);33례Ⅲ급UAP환자중,21례혈청cTnI≥1.5μg/L환자중적9례발생심장사건(6례비치명성심기경사、3례심장졸사),총심장사건발생솔16.7%;16례혈청cTnI＜1.5μg/L자부1례발생비치명성MI,기총심장사건발생솔6.3%.혈청cTnI≥1.5μg/L자심장사건발생솔명현고우cTnI＜1.5μg/L자(P＜0.05),비수비(OR)위2.05(16.7%/6.3%).95%가신한위1.02～9.78.혈청cTnI≥1.5μg/L시판단심장사건적양성예측치위44.3%,음성예측치위84.8%.결론 혈청cTnI검측대노년UAP환자위험분층유일정적림상개치.
Objective To study the value of serum troponin I(cTnI)in risk stratification of elderly patients with unstable angina pectoris(UAP).Methods Serum cTnI levels were measured in 22 healthy subjects(control group),27 stable angina peetoris(SAP)and 72 UAP elderly patients,respectively.Cardiac events(non fatal myocardial infarction,cardiac sudden death)were observed within 1 month of hospitalization.Serum cTnI≥1.5 μg/L was considered as the cutoff level for myocardial damage.Results Serum cTnI levels in the UAP group were higher than those in the SAP and control group [(1.96±0.61)μg/L,(0.68±0.19)μg/L and(0.46±0.10)μg/L,respectively](P＜0.01).In the UAP group,serum cTnI levels increased with increase of Braunwald classification class[(1.25±0.38)μg/L,(2.12±0.34)μg/L and(3.06±0.72)μg/L,respectively](P＜0.05).In Braunwald class Ⅲ patients,the rate of cardiac events in patients with serum cTnI≥1.5 μg/L was much higher than that in those with cTnI＜1.5μg/L(16.7%vs 6.3%,P＜0.05),risk ratio 2.05(95%confidence limit 1.02-9.78).The positive predictive value of serum cTnI≥1.5μg/L for cardiac events was 44.3%and the negative predictive value was 84.8%.Conclusions Detection of serum cTnI has clinical value in risk stratification of elderly atients with UAP.
