检测血清心脏肌钙蛋白Ⅰ在老年急性冠状动脉综合征的临床应用价值

Value of Serum Troponin I in Elderly Acute Coronary Syndrome

目的:探讨血清心脏肌钙蛋白I(CTnI)在老年急性冠状动脉综合征中的诊断价值。方法:对58例老年急性冠状动脉综合征患者,分别于入院即刻、第4天及第7天各取静脉血1次,31例对照组空腹取血一次,分别测定CTnI及CK-MB值并加以比较。结果-AMI组患者入院即刻、第4天、第7天CTnI高于上限值者分别有25例(100%)、23例(92%)、16例(64%)。CK-MB高于正常者分别有25例(100%)、3例(16%)、0例。入院即刻急性心肌梗死(AMI)组、不稳定性心绞痛(UAP)组测定CTnI与对照组间有显著性差异,分别为P<0.01、P<0.05。CKMB测定值在AMI与对照组间有显著性差异(P<0.01),在UAP组与对照组间无显著性差异(P>0.05)。结论:CTnI在心肌损伤早期具有较高的敏感性及特异性,CTnI明显增高不仅可用于AMI特异性诊断,其轻度增高对UAP诊断亦应引起重视。

Objective:To evaluate the diagnostic value of serum troponin I(CTnI)in elderly acute coronary syndrome. Methods: CTnI and CK-MB were measured in 31 healthy persons and 58 elderly acute coronary syndrome patients at admission,4 and 7 days after admission. Results:Patients with CTnl greater than upper limit at admission, 4 and 7 days after admission in acute myocardial infarction(AMI)group was 25(100%),23(92%),and 16(64%)respectively,and with CK-MB greater than control group was 25(100%),3(16%), and 0 respectively. There was a significant difference in CTnI at admission between AMI,unstable angina pectoris(UAP) ,and control group (P<0.01,P<0.05,respectively). There was a significant difference in CK-MB between AMI and control group( P< 0.01), and no significant difference between UAP and control group(P>0.05).Conclusion:CTnI is a sensitive and specific marker in early myocardial damage and useful in diagnosing AMI and UAP.