不同性别和年龄的非心肌损伤人群血清高敏心肌肌钙蛋白T水平差异

Gender and Age Differences in Serum High-sensitivity Cardiac Troponin T Levels in Non-myocardial Injury Population

目的:研究非心肌损伤人群中血清高敏心肌肌钙蛋白T(hs-cTnT)水平是否有年龄和性别差异,为hs-cTnT在临床的更好应用提供理论基础。方法:回顾性分析2017年1月至2018年9月来我院因胸痛需检测血清hs-cTnT的就诊者资料。根据临床检查基本排除引起血清hs-cTnT水平升高的非心脏因素;根据临床症状和体征、心电图、血清hs-cTnT和N末端B型利钠肽原水平,初步排除心肌受损的因素。结果:共纳入29114例患者,其中男性占53.0%。分析结果显示,血清hs-cTnT水平整体呈偏态分布,中位数(四分位数间距)为7(4~19)ng/L。男性的血清hs-cTnT水平高于女性,差异有统计学意义(P<0.05)。不论男性还是女性,随着年龄增长,血清hs-cTnT水平逐渐升高,各年龄段之间的差异均有统计学意义(P均<0.05);随着年龄增长,血清hs-cTnT水平低于检测限的比例逐渐变低,女性中最高比例达37.10%,而男性中最高比例为20.36%。7岁以下儿童中,不同年龄段的血清hs-cTnT水平存在差异:1岁前较高,此后逐渐下降,6岁左右达到成年人水平。结论:在非心肌受损人群中,血清hs-cTnT水平随着年龄增长而升高;男性血清hs-cTnT水平高于同年龄的女性。随着年龄增长,血清hs-cTnT水平低于检测限的比例逐渐降低;与同年龄段男性相比,女性更不容易检测出hs�cTnT。7岁以下儿童不同年龄段的血清hs-cTnT水平有差异,1岁前较高,随着年龄增长逐渐下降,6岁达到成年人水平。

Objectives:To study whether the high-sensitivity cardiac troponin T(hs-cTnT)level is influenced by the age and gender in non-myocardial injury population,and provide a theoretical basis for better clinical application and evaluation of hs-cTnT.Methods:This retrospective analysis was performed in patients admitted in our hospital from January 2017 to September 2018 with serum hs-cTnT measurement due to chest pain.Patients with known non-cardiac factors,which might result in elevated serum hs-cTnT levels were excluded based on clinical examination.Patients with myocardial injury were also excluded based on clinical symptoms and signs,electrocardiogram,serum hs-cTnT and N terminal pro B type natriuretic peptide levels.Results:A total of 29114 patients were included,53.0%were males.The serum hs-cTnT levels displayed as a skewed distribution with a median(interquartile range)of 7(4-19)ng/L.In comparison with females,serum hs-cTnT level was significantly higher in males(P<0.05).Moreover,the serum hs-cTnT levels gradually increased with age,and the differences between the age groups were statistically significant(P<0.05)regardless the gender of patients.The proportion below the detection limit increased proportionally with age with the highest rate of females(37.10%),while that of males was 20.36%.Furthermore,there were some discrepancies among children under 7 years,serum hs-cTnT level was relatively high at age<1 year,this level gradually declined with age and approached adult level at age around 6 years.Conclusions:Our results indicate that the serum hs-cTnT levels increase with age in non-myocardial injury population.Among patients of same age,the serum hs-cTnT level of males is higher than in females.The proportion below the detection limit gradually declines with age,especially in females.Additionally,the serum hs-cTnT test results among children is relatively high at age<1 year.This level gradually declines with age and approaches adult level at age around 6 years.