cTnI及hs.doc

cTnI及hs 　【关键词】 肌钙蛋白I；超敏C ［摘 要］ 目的：比较血清心脏肌钙蛋白I(cTnI)，超敏C反应蛋白(hsCRP)及二者联合检测对不稳定心绞痛(UAP)患者近期预后判断价值。方法：对49例健康人、32例稳定心绞痛(SAP)和58例UAP患者分别进行cTnI，hsCRP检测，并对UAP患者进行随访，时间为3个月，观察心脏事件发生率。结果：58例UAP患者中，26例(44.8％)cTnI高于正常，22例(37.9%)hsCRP高于正常，二者阳性率无统计学差异(Pgt;0.05)。随访期间心脏事件发生率，cTnI和hsCRP升高组分别为65.4％和36.4％，明显高于cTnI和hsCRP正常组(分别为18.8％和5.6％，其发生率有统计学差异Plt;0.01)。血清cTnI水平预测UAP患者随访期间心脏事件，其敏感度(73.9％)、特异度(74.3％)、阴性预测值(81.3％)与hsCRP有可比性(分别为80.0％、70.8％、94.4％)二者无统计学差异(Pgt;0.05)。阳性预测值cTnI(65.4％)高于hsCRP(36.4％)，其差异有显著性(Plt;0.01)。cTnI和hsCRP同时升高组，阳性预测值和特异度都明显高于cTnI或hsCRP升高组，二者有统计学差异(Plt;0.01)。结论：cTnI和hsCRP测定可较敏感地反映微小心肌损伤(MMD)，联合检测更可提高阳性预测值和特异度，对于预测UAP的近期预后，cTnI和hsCRP都有较好的临床价值。 　　［关键词］ 肌钙蛋白I；超敏C反应蛋白；不稳定心绞痛预后 　　Compare the Shortterm Prognostic Value of cTnI，hSCRP and both of then in Unstable Angina 　　Abstract:Objective To compare the shortterm prognostic value of cTnI，hsCRP and both of then in unstable angina(UAP).Methods Blood samples from 58 patients with UAP，32 patients with stable angina(SAP)and 49 healthy persons were collected serially and cTnI，hsCRP were detected respectively.Coronary angiography was performed in all UAP patients and all UAP patients were followedup during three months.Results Among the UAP patients，positive rate of cTnI(26 of 58，44.8％)，hsCRP(22 of 58，37.9％) was significantly higher than that of healthy persons.positive rate of cTnI(26 of 58，44.8％)was not significantly higher than that of hsCRP(22 of 58，37.9％，Pgt;0.05).Incidence of cardiac event during observation with positive cTnI and hsCRP(65.4％ and 36.4％，respectively)was significantly higher than in patients with normal cTnI and hsCRP(18.8％ and 5.6％ respectively，Plt;0.01).Inpredicting cardiac events during observation，the sensitivity，specificity，and negative predictive value(NPV) (73.9％，74.3％and 81.3％)was comparable with hsCRP(80.0％，70.8％and 94.4％ Pgt;0.05)，but cTnI level had higher positive predictive value(PPV) than hsCRP(65.4％ vs 36.4％，Plt;0.01).Both positive cTnI and hsCRP，positive predictive value(PPV) and specificity we