高敏肌钙蛋白T与不稳定型心绞痛患者冠脉病变及预后的关系

目的：探讨不稳定型心绞痛（UAP）患者高敏肌钙蛋白T（hs-cTnT）水平与冠状动脉病变及预后的关系。方法156例UAP住院患者常规测定hs-cTnT水平,根据hs-cTnT水平分为hs-cTnT阳性组（44例）,阴性组（112例）。住院期间行冠状动脉造影（CAG）检查,随访30 d,记录心血管不良事件。结果 hs-cTnT阳性组冠脉造影阳性率93.2%,三支病变的发生率37.7%,冠状动脉内血栓发生率18.2%,均明显高于阴性组；hs-cTnT阳性组hs-cTnT水平随着冠脉病变的严重程度而升高,30 d内总的心脏事件发生率（25%）,明显高于hs-cTnT阴性组（5.5%）,两组相比差异有统计学意义（P〈0.01）。结论 hs-cTnT水平的高低可预测UAP患者冠脉病变的严重程度及其病变范围,其升高提示短期预后不良,主要心血管事件发生率增加,可作为UAP早期危险分层的指标,对指导治疗亦有重要意义。

Relationship between high-sensitivity cardiac troponin T and the severity of coronary artery and prognosis in patients with coronary artery disease

Objective To investigate the relationship between high-sensitivity troponin T and the severity of coronary artery and prognosis in patients with coronary artery disease. Methods The level of hs-cTnT of 156 hospitalized patients with UAP was determined routinely. The patients were divided into hs-cTnT-positive group （44 cases） and negative group （112 cases） according to the level of hs-cTnT. During hospitalization, all of the patients underwent coronary angiography （CAG）, after discharge, they were followed for 30 days,and cardiovascular adverse events were recorded. Results The positive rate of coronary angiography was 93.2%in hs-cTnT positive group, and the incidence of three-vessel disease was 37.7%, the incidence of coronary thrombosis was 18.2%, and all of them were significantly higher than the negative group. In the hs-cTnT positive group, the level of hs-cTnT increased with the severity of coronary artery disease, the rate of 30-days-total-cardiac-event was 25%, and was significantly higher than the hs-cTnT negative group （5.5%）, the difference was statistically significant （P〈0.01）. Conclusion The level of hs-cTnT can predict the severity of coronary artery disease in patients with UAP, the elevated prompt poor short-term prognosis, increased risk of major cardiovascular events, hs-cTnT levels can be used as indicators of the UAPearly risk stratification, to guidetreatment also of great significance.