心肌肌钙蛋白T对梗死后心绞痛病人预后的判断价值

THE PROGNOSTIC VALUE OF SERUM CARDIAC TROPONIN T ON EARLY POSTINFARCTION ANGINA

目的探讨心肌肌钙蛋白Ｔ（ｃＴｎＴ）对梗死后心绞痛（ＰＡ）病人预后的判断价值。②方法急性心肌梗死（ＡＭＩ）发生１０ｄ后，连续２０ｄ检测１２６例ＰＡ病人血清ｃＴｎＴ和肌酸磷酸激酶同工酶ＭＢ（ＣＫ－ＭＢ），随访０．５年，观察心脏事件（再梗死、猝死或严重心力衰竭）的发生率。③结果连续２０ｄ检测，ｃＴｎＴ均正常（ｃＴｎＴ≤０．２μｇ／Ｌ）者２６例，随访期内只有１例发生心脏事件；ｃＴｎＴ升高≤１０次者５１例，随访期内发生心脏事件１２例，其中非Ｑ波心肌梗死４例，Ｑ波心肌梗死８例；ｃＴｎＴ升高＞１０次者４９例，随访期内发生心脏事件２９例，其中非Ｑ波心肌梗死２０例，Ｑ波心肌梗死９例。特别是非Ｑ波心肌梗死后的ＰＡ病人，其心脏事件的发生率明显高于Ｑ波心肌梗死（χ２＝１５．３２，Ｐ＜０．００１）。ＣＫ－ＭＢ升高者１３例，随访期内发生心脏事件５例。④结论血清ｃＴｎＴ监测可以判断ＰＡ病人的预后，ｃＴｎＴ持续升高者，预后不良。

Objective\ To evaluate the prognostic value of serum cardiac troponin T(cTnT) on postinfarction angina(PA).\ Methods\ Serum cTnT and creatine kinase isoenzyme (CK MB) in 126 patients with PA 10 days after AMI were measured for 20 days. The incidence of cardiac events was observed during the follow up survey (y=0.5).\ Results\ Of the 126 patients with PA 10 days after AMI, 26 patients were with normal cTnT levels in all blood samples, only 1 patient had cardiac event within 6 months. 51 patients were with positive cTnT levels in less than 10 blood samples, 12 of these patients had cardiac events within 6 months. 49 patients were with positive cTnT levels in more than 10 blood samples, 29 of these patients had cardiac events within 6 months. 13 patients were with positive CK MB in less than three blood samples, and 5 patients had cardiac events.Conclusion\ Detecting serum cTnT can be applied to the determination of prognosis of PA patients. PA patients with persistent and positive cTnT have bad prognosis.