不稳定性心绞痛和急性心肌梗塞肌钙蛋白T变化的比较

目的 :比较不同急性冠状动脉综合征患者肌钙蛋白 T(Tn T)变化。　　方法 :不稳定性心绞痛 (UAP)、Q波型和非 Q波型急性心肌梗塞 (AMI)患者于急诊就诊时、住院后第 2、第 3和第 6日取血测定 Tn T水平。　　结果 :35 %的 UAP患者 Tn T表现为升高 ,其升高的幅度 (均 <3.0 ng/ ml)明显 <非 Q波型 AMI(2 4% >3.0 ng/ml)和 Q波型 AMI(90 % >3.0 ng/ ml) ,且一般 3天后即转为阴性 ,而 AMI患者 6天后多数仍为阳性。非 Q波型 AMI和Q波型 AMI急诊就诊时 Tn T的阳性率分别为 79.1%和 90 .7% ,住院后第 2日均达 10 0 % ,均明显高于同时间谷草转氨酶和肌酸激酶同工酶的阳性率 ,两组 Tn T阳性在持续时间上相似 ,但在升高幅度上有明显的区别。再灌注治疗可能会影响 Q波型 AMI患者 Tn T的自然变化规律。　　结论 :UAP患者 Tn T的变化与非 Q波型 AMI和 Q波型 AMI有显著的不同。

Troponin T Changes in Unstable Angina and Acute Myocardial Infarction

Objective:To determine the different changes of troponin T (TnT) level among unstable angina (UAP),non Q wave and Q wave acute myocardial infarction (AMI). Methods:Blood sample of TnT,GOT and CK MB taken at day 1,2,3 and 6 during hospitalization were measured. Results:An increase in TnT levels were found in 35% of paitents with UAP.However,the TnT levels in UAP (<3 0ng/ml in all patients) at day 1,2 and 3 were significantly lower than that in non Q wave AMI (>3 0ng/ml in 24% patients) and in Q wave AMI (>3 0ng/ml in 90% patients) and the TnT levels at day 6 in most of UAP patients turned to be negative.In AMI patients at day 6 it remained to be possitive.The positive rates of TnT in non Q wave and Q wave AMI at emergency room were 79 1% and 90 7%,respectively,which were significantly higher than that of GOT and MB isoenzyme of creatine kinase (CK MB).Reperfusion may have an impact on TnT changes in AMI. Conclusion:There were obvious differences in TnT changes in UAP,non Q wave and Q wave acute myocardial infarction.