高敏肌钙蛋白T与常规肌钙蛋白T在急性冠状动脉综合征中的对比研究

Application of serum hs-cTnT and conventional TnT in diagnosis of acute coronary syndrome

目的对比分析急性冠状动脉综合征(ACS)患者血清高敏肌钙蛋白T(hs-cTnT)与常规肌钙蛋白T(cTnT)早期诊断急性心肌梗死(AMI)的价值。方法连续入选拟诊ACS患者215例,依据诊断分为AMI组59例,不稳定性心绞痛(UAP)组103例,非冠状动脉粥样硬化(非CHD)组53例。入院即刻测定血清cTnT、hs-cTnT水平。应用ROC曲线比较hs-cTnT、常规cTnT对AMI早期诊断的敏感性和特异性。结果 AMI组血清hs-cTnT和常规cTnT均高于UAP组和非CHD组(P<0.05)。hs-cTnT与常规cTnT诊断AMI的ROC曲线下面积分别为0.936、0.880(P=0.000);hs-cTnT敏感性为88.1%,特异性为84.6%,cTnT分别为76.3%、99.4%。hs-cTnT水平与Gensini积分呈正相关(P<0.05),与冠状动脉病变支数无关(P>0.05)。结论 ACS患者中,hs-cTnT对早期诊断AMI可能较常规cTnT更敏感,可尽早检测出更多的AMI患者。

Objective To analyze the value of serum hs-cTnT and conventional TnT（cTnT） in ear- ly diagnosis of acute myocardial infarction （AMI） in patients with acute coronary syndrome （ACS）. Methods Two hundred and fifteen ACS patients were divided into AMI group（n=59）, unstable angina pectoris（UAP） group（n=103）,and non coronary atherosclerosis group（n=53）. Their serum cTnT and hs-cTnT levels were measured at admission. The value of serum cTnT and hs-cTnT levels for the early diagnosis of AMI was compared according to the receiver operating characteristic（ROC） curve. Results The serum hs-cTnT and cTnT levels were higher in AMI group than in UAP group and non coronary atherosclerosis group（P（0.05）. The area under the ROC curve was 0. 936 and 0. 880,respectively,for the diagnosis of AMI with serum hs-cTnT and cTnT（P=0. 000）. The sensitivity and specificity of hs-cTnT and cTnT were 88.1% and 84.6%, 76.3% and 99.4% ,respectively,in diagnosis of AMI. The serum hs-cTnT level was positively re- lated with the Gensini score（P〈0.05）. Conclusion hs-cTnT is more sensitive than cTnT in early diagnosis of AMI in ACS patients.