心脏肌钙蛋白Ⅰ定性试验临床应用研究

Clinical study of cardiac troponin I qualitative test

目的研究心脏肌钙蛋白Ⅰ(cTnI)定性试验临床应用价值。方法应用cTnI定性试验检测盒,对67例急性心肌梗死、117例不稳定心绞痛、82例胸痛待查、35例心力衰竭、骨折及心脏外科手术各10例,正常人20例,测定系列cTnI,并作临床随访。结果急性心肌梗死67例全部呈阳性反应,最早出现在胸痛后2h,24h内100%阳性,阳性结果可持续7至14d。9例不稳定心绞痛cTnI阳性,其中3例发生急性心肌梗死或冠心病猝死。82例胸痛而cTnI阴性者无一例发生冠心病事件。35例心力衰竭有8.5%cTnI阳性。心脏外科手术cTnI阳性者占80%,骨骼肌损伤者10例cTnI均阴性。20例正常健康人cTnI均阴性。结论cTnI定性试验诊断急性心肌梗死敏感、特异、准确,对不稳定心绞痛有助于判断疾病预后。胸痛而24h内cTnI阴性者不发生冠脉事件。实验方法简便易行,结果迅速可靠,值得推广应用。

Objective To investigate clinical applied value of cardiac troponin I qualitative test.Methods 67cases of acute myocardial infarction,117cases of unstable angina,82cases of chest pain,35cases of heart failure,10cases of fracture,10cases of cardiac operation,20cases of normal person,all of them were determined of cTnI and foll owed up.Results All of 67casee of acute myocardial in farction were positive reaction,first showed at 2h after chest pain,positive rate was of100%in 24h,the positive appearance continued 7～14d.Nine cases of unsta ble angina were positive of cTnI,3ca ses of them suffered from acute myocardial infa rction or sudden death of coronary heart disease.There were not coronary events in 82cases of chest pain with negative cTnI.Posit ive cTnI was of 8.5%in 35cases of heart failure.Positive cTnI was of 80%in10cases of cardiac operation,10cases of skele tal muscle injury and 20cases of norm al person showed negative.Conclusions cTnI qualitative test was sensitive,specific and accurate to acute myocardi al infarction,and was helpful for evaluating prognosis of unstable angina.The patients of chest pain with negative cTnI in 24h didn 't suffer from coronary events.The method of the test was simple,the results were reliabl e and it was worth of extensive applic ation.