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目的 探讨肌钙蛋白(cTn)Ⅰ对急性肺栓塞(APE)危险程度及预后的评判价值.方法 收集本院2007年1月至2013年12月178例APE患者并按照入院时cTn Ⅰ水平分为cTn Ⅰ+组(≥0.012 ng/ml)及cTn Ⅰ-组(＜0.012 ng/ml),两组分别采用肺栓塞严重指数(PESI)进行危险分层,并记录两组心电图、超声心动图、影像学结果及发生良性及不良事件情况.结果 178例APE患者中cTn Ⅰ+96例(53.9％),cTn Ⅰ-82例(46.1％),“不良事件”发生情况,cTn Ⅰ+与cTn Ⅰ-分别为71例(74.0％)、0例(P =0.000),“良性事件”发生情况,cTn Ⅰ+与cTn Ⅰ-分别为80例(83.3％)及18例(22.0％)(P=0.000),Kaplan-Meier曲线表明,cTn Ⅰ-组较cTn Ⅰ+组具有更低的良性及不良事件发生率.结论 cTn Ⅰ是评价APE危险程度及预后的一项重要指标.“,”Objective To investigate the assessment of risk stratification and prognostic value of cardiac troponin Ⅰ (cTn Ⅰ) in patients with acute pulmonary embolism (APE).Methods A total of 178 patients with APE in our hospital from January 2007 to December 2007 were collected and divided into cTn Ⅰ + group (0.012 ng/ml) or higher and cTn Ⅰ-group (＜0.012 ng/ml) according to the initial inspection cTn Ⅰ level.The pulmonary embolism severity index (PESI) was used for clinical risk determination and electrocardiography (ECG),echocardiography,imaging results,and positive and adverse events were recorded.Results Among 178 consecutive patients with confirmed acute PE;96 (53.9％) were cTnⅠ + and 82 (46.1％) were cTnⅠ-.“hard events” cTn Ⅰ + and cTn Ⅰ-71 cases (74.0％) and 0,respectively (P =0.000).“soft events” cTn Ⅰ + and cTn Ⅰ-were 80 cases (83.3％) and 18 cases (22.0％),respectively (P =0.000).Kaplan Meier curve showed that patients in cTn Ⅰ-groups had higher survival free of hard (P =0.000) or soft (P =0.000) events,irrespective of clinical risk.Conclusions Highly sensitive cTn Ⅰ assay provides an excellent prognostic negative predictive value,thus it has a role in identification of candidates for out-of-hospital treatment of acute PE.