cTnT与CK--MB在胸痛危险分层中的作用

目的评价心肌肌钙蛋白T(cTnT)与肌酸激酶同工酶-MB(CK-MB)蛋白量在胸痛危险分层中的作用。方法对所有病例进行12h床边动态监测，包括基线、4、8、12h的连续心律监测和12导联心电图(ECG)测试；与此同时分别于基线、4、8、12h对入选胸痛组的其中383例患者测定cTnT、CK-MB。结果383例CPU患者只有8例(2．1％)CK-MB阳性，39例cTnT阳性。cTnT状态与随访的结果表明，cTnT阳性明显早于CK-MB。89％cTnT阳性患者血管造影术显示发生冠状动脉疾病(CAD)及多支血管病。结论cTnT比CK-MB在评估伴心肌坏死和多支血管病的胸痛危险分层中具有更高的敏感性与特异性；常规测定cTnT更便于胸痛的危险分层与处理。

The value of cardiac troponin T and creatine kinase-MB in chest pain risk stratification

Objective To evaluate the value of cardiac troponin T(cTnT)and MB isoenzyme of creatine kinase(CK-MB) in chest pain risk stratification.Methods All patients underwent care path-driven observation for 12 hours(h),including continuous cardiac rhythm monitoring and serial 12-lead electrocardiograrams(ECG)at baseline,4,8,12 h.cTnT and CK-MB were measured.Results Among the 383 chest pain patients,only 8(2.1%)were CK-MB positive and 39(10.2%)were cTnT positive.positive cTnT was present earlier than CK-MB.Eighty_nine of cTnT positive patients had angiographically significant coronary artery disease and multivessel disease.Conclusion cTnT was more sensitive and specific than CK-MB in risk stratification for chest pain patients with myocardial necrosis and multivessel disease.Routine use of cTnT in chest pain patients is helpful in risk stratification and management.