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目的 探讨心肌肌钙蛋白 I(c Tn I)和肌红蛋白 (Mb)对不稳定型心绞痛 (U A)患者近期、远期心脏事件的预后评价。方法 对 6 4例 U A患者进行血清 c Tn I和 Mb定量测定 ,同时测定肌酸磷酸激酶同工酶 MB(CK- MB)活性 ,分组比较标志物升高与近期、远期心脏事件的关系。结果 近期 (30 d) c Tn I正常组与增高组心脏事件发生率分别为 2 .3%和 2 8.6 % (P<0 .0 0 5 ) ,远期分别为 2 .4 %和 2 0 .0 % (P<0 .0 5 )。近期 Mb正常组与增高组心脏事件发生率 (5 .0 % vs 2 0 .8% ,P<0 .0 5 )亦有显著差异。 c Tn I和 Mb对预测近期心脏事件发生的灵敏度分别为 85 .7%和71.4 % ,阴性预测值为 97.7%和 95 .0 %。远期预后判断中 ,c Tn I的灵敏度为 80 .0 % ,阴性预测值 97.6 %。校正性别、年龄等基线特征、冠状动脉病变及标志物升高等因素后 ,c Tn I是近期及远期发生心脏事件独立的危险性预测因子 ,比数比 (OR值 )分别为 8.5 5 0 (P<0 .0 5 )和 4 .777(P<0 .0 5 )。结论 c Tn I联合 Mb是评估 U A患者预后的良好指标 ,c Tn I可用于指导临床治疗 ,是 U A患者近期、远期严重心脏事件发生独立的危险性预测因子。
Objective To investigate the prognostic evaluation of cardiac troponin I (cTn I) and myoglobin (Mb) in short-term and long-term cardiac events in patients with unstable angina pectoris (UA). Methods Serum levels of cTn I and Mb were measured in 64 UA patients. Simultaneously, creatine phosphokinase MB (CK-MB) activity was measured. The relationship between elevated markers and short-term and long-term cardiac events was compared. Results The incidence of cardiac events in the normal group and the elevated group was 2.3% and 22.6% (P <0.05), respectively, in the short term (30 days) and 2.4% and 20% in the long term. 0% (P <0. 05). The recent incidence of cardiac events in normal and elevated Mb groups was also significantly different (5.0% vs 20.8%, P <0.05). The sensitivity of cTn I and Mb to predicting recent cardiac events were 85.7% and 71.4%, respectively, with negative predictive values of 97.7% and 95.0%. In the long-term prognosis, the sensitivity of cTn I was 80.0% and the negative predictive value was 97.6%. After adjusting for baseline characteristics such as gender and age, coronary artery disease, and elevated markers, cTn I was an independent risk predictor of recent and long-term cardiac events with odds ratios of 8.5 5 0 (OR) P <0. 05) and 4 .777 (P <0. 05). Conclusions cTnI combined with Mb is a good indicator to evaluate the prognosis of UA patients. CTnI can be used to guide the clinical treatment. It is an independent risk predictor of recent and long-term serious cardiac events in UA patients.