心脏肌钙蛋白Ⅰ在不稳定型心绞痛患者预后预测中的价值

目的　探讨心脏肌钙蛋白Ⅰ (cTnI)对不稳定型心绞痛患者危险度的预测价值。方法　对 70例不稳定型心绞痛 (UAP)患者进行血清cTnI、肌酸磷酸激酶同工酶 (CK MB)测定 ,并随访 1年 ,观察其心脏事件的发生情况。结果　 70例UAP患者中 2 2例cTnI浓度 >0 .0 3μg/L。随Braunwald临床分级增高 ,血清cTnI浓度升高 (P <0 .0 5 )。Ⅲ级UAP患者血清cTnI阳性率高于Ⅰ、Ⅱ级 ,心脏事件发生率均高于Ⅰ、Ⅱ级 (P <0 .0 5 )。血清cTnI阳性组心脏事件发生率 4 5 .4 % ,血清cTnI阴性组发生率 6 .3% ,血清cTnI预测心脏事件的灵敏度为 76 .9% ,特异度为78.9% ,阳性预测价值为 4 5 .4 % ,阴性预测价值为 93.8%。结论　血清cTnI测定对UAP患者的预后有较好的预测价值

Prognostic Value of Cardiac Troponin Ⅰ (cTnI) in Patients with Unstable Angina Pectoris

Objective\ This study assessed the prognostic value of cardiac troponin I ( cTnI) in patients with unstable angina pectoris (UAP). Methods\ cTnI and creatine kinase MB isoenzyme (CK MB) were analyzed in 70 patients with UAP and they were visited during the first year in which their rates of major adverse cardiac events were observed. Results\ Elevated serum level of cTnI were found in 22 patients with UAP(>0.03 μg/L). Concentrations of cTnI in Braunwald class Ⅲ were higher than those in class Ⅰ and Ⅱ. The incidence of major adverse cardiac events was higher in class Ⅲ than that of class Ⅰ and Ⅱ. The incidence of major adverse cardiac events was 45.4% in elevated serum level of cTnI patients with and 6.3% in patients with non elevated serum level of cTnI. The sensitivity of predicting adverse cardiac events by serum cTnI was 76.9% and specificity was 78.9%. Conclusion\ This study provides the evidence to elevated serum cTn I in some patients with unstable angina pectoris. cTnI could be a sensitive and specific biochemical marker of not only myocardial cell damage, but also a predictor of worse prognosis.