高敏肌钙蛋白T与常规肌钙蛋白T在急性冠状动脉综合征中的对比研究

目的对比分析急性冠状动脉综合征(ACS)患者血清高敏肌钙蛋白T(hs-cTnT)与常规肌钙蛋白T(cTnT)早期诊断急性心肌梗死(AMI)的价值。方法连续入选拟诊ACS患者215例,依据诊断分为AMI组59例,不稳定性心绞痛(UAP)组103例,非冠状动脉粥样硬化(非CHD)组53例。入院即刻测定血清cTnT、hs-cTnT水平。应用ROC曲线比较hs-cTnT、常规cTnT对AMI早期诊断的敏感性和特异性。结果 AMI组血清hs-cTnT和常规cTnT均高于UAP组和非CHD组(P<0.05)。hs-cTnT与常规cTnT诊断AMI的ROC曲线下面积分别为0.936、0.880(P=0.000);hs-cTnT敏感性为88.1%,特异性为84.6%,cTnT分别为76.3%、99.4%。hs-cTnT水平与Gensini积分呈正相关(P<0.05),与冠状动脉病变支数无关(P>0.05)。结论 ACS患者中,hs-cTnT对早期诊断AMI可能较常规cTnT更敏感,可尽早检测出更多的AMI患者。

Application of serum hs-cTnT and conventional TnT in diagnosis of acute coronary syndrome

Objective To analyze the value of serum hs-cTnT and conventional TnT(cTnT) in early diagnosis of acute myocardial infarction(AMI) in patients with acute coronary syndrome (ACS).Methods Two hundred and fifteen ACS patients were divided into AMI group(n = 59), unstable angina pectoris(UAP) group(n=103),and non coronary atherosclerosis group(n= 53). Their serum cTnT and hs-cTnT levels were measured at admission.The value of serum cTnT and hs-cTnT levels for the early diagnosis of AMI was compared according to the receiver operating characteristic(ROC) curve.Results The serum hs-cTnT and cTnT levels were higher in AMI group than in UAP group and non coronary atherosclerosis group(P<0.05).The area under the ROC curve was 0.936 and 0.880,respectively,for the diagnosis of AMI with serum hs-cTnT and cTnT(P = 0.000).The sensitivity and specificity of hs-cTnT and cTnT were 88.1%and 84.6%, 76.3%and 99.4%,respectively,in diagnosis of AMI.The serum hs-cTnT level was positively related with the Gensini score(P<0.05).Conclusion hs-cTnT is more sensitive than cTnT in early diagnosis of AMI in ACS patients.