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目的:明确肌钙蛋白Ⅰ(cTnI)在心源性呼吸困难的鉴别诊断中有无应用价值。方法:比较急性心衰与急性肺源性呼吸困难时cTnI的变化情况,并观察一定的cTnI临界值辅助诊断心衰的敏感性和特异性。结果:总共156例患者,最后确诊为急性心衰的患者69例,而肺源性呼吸困难患者87例。急性心衰组的平均cTnI值为0.76±0.85ng/dL,而肺源性呼吸困难组为0.25±0.32ng/dL,两组间有显著性差异(P<0.001)。根据ROC曲线计算肌钙蛋白Ⅰ的临界值(截点值)为0.42ng/dL,其鉴别心衰的敏感度为71.53%,特异度为90.36%,准确度为80.14%。结论:检测肌钙蛋白Ⅰ水平并与其它临床信息相结合,有助于快速准确地诊断充血性心力衰竭。
Objective: To determine the value of cTnI in differential diagnosis of cardiogenic dyspnea. Methods: The changes of cTnI in patients with acute heart failure and acute pulmonary-derived dyspnea were compared. The sensitivity and specificity of cTnI for diagnosis of heart failure were observed. Results: A total of 156 patients, with the final diagnosis of acute heart failure in 69 patients, and 87 patients with pulmonary dyspnea. The average cTnI of acute heart failure group was 0.76 ± 0.85ng / dL, while that of pulmonary dyspnea group was 0.25 ± 0.32ng / dL, with significant difference between the two groups (P <0.001). According to the ROC curve, the cutoff value of troponin I was 0.42ng / dL. The sensitivity and specificity of detecting troponin I was 71.53%, 90.36% and 80.14% respectively. Conclusion: The detection of troponin I and its combination with other clinical information are helpful for rapid and accurate diagnosis of congestive heart failure.