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目的探讨心肌肌钙蛋白I(cTnI)和肌钙蛋白T(cTnT)对急性缺血性心脏病转归的影响。方法对就诊的急性缺血性心脏病患者定性测定入院时及距胸痛发作间隔10h的cTnI和定量测定相同时点的cTnT。同时随访患者发病后1、3、6、12个月的疾病转归,以心绞痛、心肌梗死、心力衰竭、心源性猝死为终点评价指标。结果cTnI或cTnT异常患者与正常者相比较,不稳定型心绞痛、心肌梗死、心力衰竭、心源性猝死的发生率具有显著性差异(P<0.01)。cTnI或cTnT异常与终点事件(不稳定型心绞痛、心肌梗死、心力衰竭、心源性心源性猝死)发生率呈正相关。结论cTnI或cTnT对急性心肌梗死,尤其是微小心肌坏死诊断具有高度的敏感性和特异性,并与急性缺血性心脏病的预后密切相关。
Objective To investigate the effects of cardiac troponin I (cTnI) and troponin T (cTnT) on the outcome of acute ischemic heart disease. Methods Qualitative determination of cTnI in patients with acute ischemic heart disease at admission and at 10 h intervals from chest pain onset and quantification of cTnT at the same time point. At the same time, the patients were followed up for 1, 3, 6, and 12 months after the onset of disease. Angina, myocardial infarction, heart failure and sudden cardiac death were used as the end points to evaluate the outcome. Results The incidence of unstable angina pectoris, myocardial infarction, heart failure and sudden cardiac death were significantly different between patients with cTnI and cTnT abnormalities (P <0.01). There was a positive correlation between cTnI or cTnT abnormalities and the incidence of endpoints (unstable angina pectoris, myocardial infarction, heart failure, cardiogenic sudden cardiac death). Conclusion cTnI or cTnT is highly sensitive and specific for the diagnosis of acute myocardial infarction, especially for the diagnosis of mild myocardial necrosis, and is closely related to the prognosis of acute ischemic heart disease.