肌钙蛋白与急性冠状动脉综合征患者近期严重心脏事件的相关性分析

The relationship of troponin T measurement and short-term serious cardiac events in patients with acute coronary syndrome

目的 探讨肌钙蛋白T（TnT）与急性冠状动脉综合征（ACS）患者到急诊室72h内发生严重心脏事件的相关性。方法 连续观察到急诊室就诊并在24h内进行了TnT检测的ACS患者。对入选患者随访72h，计算发生严重心脏事件的可能性比率。结果 352例患者中20例在到达急诊室72h内出现严重心血管事件。可能性比率（和95％置信区间[CI]）分别为：TnT〈0．5o．g／L为0．5（0．3～0．9），0．5μg／L≤TnT≤2．0μg／L为1．6（0．4～6．5），TnT〉2．0μg／L为12．5（3．0～51．9）。结论 TnT〉2．0μg／L与ACS患者72h内发生严重心血管事件的可能性增加相关。

Objective To evaluate the relationship of troponin T（TnT） measurement and serious cardiac events during the subsequent 72 hours on patients presenting to the emergency departnient （ED） with acute coronary syndrome. Methods Observed consecutive patients presenting to the ED of the hospital. A TnT test was ordered within 24 hours of arrival for the eligible patients and in whom no serious cardiac outcome occurred before the test result was available. Patients were followed for 72 hours, and calculated likelihood ratios （LRs）. Results Of the 352 enrolled patients,20 had a serious cardiac outcome within 72 hours of ED presentation. The derived LRs（and 95% confidence interval [CI] ）were 0.5（0. 3-0.9） for TnT 〈0.5 μg/L,1.6（0.4-6.5） for 0.5 μg/L〈TnT〈2.0 μg/L,12.5（3.0-51,9）for TnT 〉2.0 μg/L. Conclusion TnT values 〉2.0 μg/L are associated with increased probability of serious cardiac events within 72 hours.