摘要
目的:探讨血清超敏肌钙蛋白T(hs-TnT)对急性冠状动脉综合征(ACS)患者的临床诊断、冠状动脉病变严重程度和短期预后价值的关系。方法:入选194例因胸痛而拟诊ACS收治入院的患者,所有患者于入院后24 h内测定血清hs-TnT水平,入院期间均完成冠状动脉造影,随访30 d并记录其主要心血管不良事件(MACE)。结果:急性心肌梗死组与非冠状动脉粥样硬化性心脏病组、心绞痛组之间的血清hs-TnT水平比较差异有显著的统计学意义(P<0.001);冠状动脉病变程度越严重,其血清hs-TnT水平越高。正常组、轻度狭窄组、中度狭窄组、重度狭窄、完全闭塞组其hs-TnT水平分别为(0.006 5±0.003 8)μg/L(、0.007 7±0.006 2)μg/L、(0.017 0±0.055 3)μg/L(、0.549 2±1.398)μg/L(、0.132 2±0.226 2)μg/L,其组间差异均有统计学意义(P<0.05);3支病变组[hs-TnT:(0.739 6±1.247 6)μg/L]与正常组[hs-TnT∶(0.006 5±0.003 8)μg/L]比较差异有统计学意义(P<0.001)。结论:在ACS患者中,血清hs-TnT可检测出更多的心肌坏死,同时其血清学水平的高低可预测冠状动脉病变的狭窄严重程度与病变范围;其升高亦可提示短期预后不佳、MACE的增加,可作为对ACS的早期危险分层的一个指标并可指导临床治疗。
Objective：This study aims to investigate the sensitivity of serum troponin T（hs-TnT） in acute coronary syndrome（ACS） in patients with clinical diagnosis、severity of coronary lesions and short-term prognostic value of relationships.Method：There were 194 cases,who were diagnosed acute coronary syndrome（ACS） because of chest pain,in this study.All patients admitted to hospital within 24 hours in serum hs-TnT level on admission were completed during the coronary angiography,30 days and record the follow-up The main adverse cardiovascular events（MACE）.Result：There were significant differences to serum hs-TnT among acute myocardial infarction group,angina pectoris group and the non-coronary atherosclerotic heart disease group（P0.001）.The more serious coronary artery disease,the higher the level of serum hs-TnT,normal,mild stenosis,moderate stenosis,severe stenosis,complete occlusion group the hs-TnT levels were（0.006 5±0.003 8） μg/L,（0.007 7±0.006 2）μg/L,（0.017 0±0.055 3）μg/L,（0.549 2±1.398）μg/L、（0.132 2±0.226 2）μg/L,The groups were statistically significant differences（P0.05）;Three lesions [hs-TnT ：（0.739 6±1.247 6）μg/L] and normal group [hs-TnT：（0.006 5±0.003 8）μg/L]also compared the differences statistically（P0.05）;For patients with acute coronary syndrome predicted the short-term prognosis,elevated serum hs-TnT its short-term cardiovascular events（sudden cardiac death,acute myocardial infarction,angina,readmission） higher than normal risk group,there statistically significant difference（P0.001）.Conclusion：In ACS patients,serum hs-TnT can be detected more myocardial necrosis,while the serum level of predictability of the severity of coronary artery stenosis and extent of disease;its short-term increase may also suggest a poor prognosis.For ACS,hs-TnT would be an early indicator of risk stratification and guide clinical treatment.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2011年第7期507-510,共4页
Journal of Clinical Cardiology
基金
上海浦东新区科技发展基金资助(No:PKJ2010-y34)
关键词
急性冠状动脉综合征
超敏TnT
冠状动脉造影
预后
acute coronary syndrome
high sensitive troponin T
coronary angiography
prognosis
