肌钙蛋白I与心电图改变对不稳定型心绞痛远期预后评价

The Value of Long-term Prognosis of Serum Cardic Troponin I and ECG Changer in Patients with Unstable Angina Pectoris

目的探讨心脏肌钙蛋白Ⅰ(cTnI)与心电图改变的关系及对不稳定型心绞痛远期预后评价价值.方法对119例UAP患者及148例健康对照者分别进行血清cTnI和心电图测定,并观察1个月和2 a内的心脏事件发生情况.结果血清cTnI升高组的UAP患者2 a内与心电图相关的心脏事件发生率为40.7%,显著高于血清cTnI正常组的14.3%(P＜0.005).RR为2.43,95%可信限1.04～5.67,血清cTnI＞0.16μg/L时,预测与心电图改变相关的2 a心脏事件发生率的敏感性69%,特异性53%,阳性预测值41%,阴性预测值78%,均高于ST段下移组和T波倒置组.而ST段升高、ST段下移和T波倒置3种心电图改变在cTnI升高组和cTnI正常组两组间2 a的心脏事件发生率却无显著差异(P＞0.05).结论血清cTnI检测对判断UAP患者2 a内发生心脏事件的危险性明显优于心电图.

Objective To evaluate the relationships between the levels of serum cardiac troponin I(cTnI) and ECG changer, and its long term predictive value for cardiac events in the patients with unstable angina pectoris(UAP).Methods Serum cTnI levels and ECG were measured in 148 healthy subjects(control group) and 119 UAP patients, respectively.Results The relation of ECG cardiac events was 40.7% in patients with higher serum cTnI group in 2 years. It was much higher than that of the patients 14.3% with normal serum cTnI levels group( P < 0.05 ) risk ratio(RR)= 2.43 , 95% confidence limi 1.04 ～ 5.67 , the sensitivity of serum cTnI≥ 0.16 ?mg/L for cardiac events in 2 years was 69%, the specificity was 53%, the positive predictive value was 41%, the negative predicative value was 78%. They were all higher than ST descent and T inversion. But the rate of cardiac events were no significantly difference in ST elevation and ST descent and T inversion of higher cTnI group and normal cTnI group in 2 years( P > 0.05 ).Conclusion Serum cTnI level shows very important predictive value for long term cardiac events in patients with UAP patients than ECG changer.