肌钙蛋白I对急性冠状动脉综合征微小心肌损伤诊断及预后判断的临床意义

Clinical significance of serum troponin I in patients with unstable angina pectoris and minor myocardial damage

目的为了评价血清心肌肌钙蛋白I(cTnI)测定对不稳定型心绞痛(UAP)患者微小心肌损伤的诊断及预后判断的临床意义。方法双抗体夹心法,测定UAP36例,稳定型心绞痛(SAP)20例和正常人31例的血清cTnI水平。UAP36例行冠状动脉造影。结果UAP组的血清cTnI阳性率(36.11%)高于SAP组(5%)和健康组(0)差异显著(P<0.05)。且UAP患者,中、高危险组cTnI阳性率(46.15%,58.33%)明显高于低危险组(P<0.05);cTnI阳性患者冠状动脉造影提示严重病变12例(1213),明显高于阴性UAP患者3例(323)(P<0.05);阳性患者的近期心脏事件发生率明显高于血清阴性者(P<0.05)。结论cTnI测定是反映心肌细胞损伤的敏感性和特异性指标,对UAP患者微小心肌损伤及预后有预测价值。

Objective To valuate the clinical significance of serum troponin I (cTnI) in patients with unstable angina pectoris (UAP) and minor myocardial damage (MMD). Methods Diplo-antibody immunofluore-scence was used to detect serum cTnI in 31 healthy subjects,20 patients with stable angina pectoris (SAP) and 36 patients with UAP.Coronary angiography was given in 36 patients with UAP. Results The positive rate of cTnI in UAP (36.11%) was significantly higher than that in SAP (5%) and in 31 healthy subjects.Among the 36 patients with UAP:In cTnI positive group, there was 12 cases (12/13) with type C lesion,frequent triple vessel and left main coronary involvement,and higher mean percentage diameter stenosis in the coronary arteries than those in cTnI negative group (3/23);The short-term cardiac events were significantly higher in cTnI positive group than that in cTnI negative group.No significant difference was found in serum CK-MB among 3 groups. Conclusion Serum cTnI demonstrates minor myocardial damage can predict the prognosis of patients with UAP.