肌钙蛋白-Ⅰ水平与不稳定性心绞痛患者近期预后的关系-临床医学专业论文.docxVIP

肌钙蛋白．I水平与不稳定性心绞痛患者近期预后的关系 肌钙蛋白．I水平与不稳定性心绞痛患者近期预后的关系 提要 y 5591 39 提要 目的本研究旨在探讨血清肌钙蛋白．1(cTn．I)水平与不稳定性心 绞痛(UAP)患者近期预后的关系。 方法对38例诊断为UAP的患者于入院后即刻、2—4小时、48 小时、72小时进行血清cTn．I定量测定，取其峰值，观察住院期间 心脏事件的发生率。38例患者中30例行冠状动然造墅。 f结果(1)38例患者随UAP Braunwald分级加重，cTn．1值呈 上升趋势(Po．01)。(2)38例UAP患者中16例(46％)cTn．I=o．31 士O．33ng／ml明显高于余22例(54％)cTn．1=0．033±0．027ng／ml (P0．01)；(3)cTn．I升高组住院期间急性心肌梗塞(AMI)、心脏性猝 死、顽固性心绞痛的发生率明显高于cTn．1正常组(45．2％比8．1％， P0．01)。应用cTn．1定量测定预测上述事件的敏感性和特异性分别 为81．8％和74．1％；其阳性和阴性预测值分别为56≯3％和90．9％。(4) cTn．I值与冠状动脉病变程度的关系尚不肯定。J／ 结论血清cTn．1值升高对判断UAP患者近期预后有较好的预测 价值。 关键词：肌钙蛋白一I心绞痛不稳定性预后 ＼／ ＼／√7 。77 作 者：杨玲 指导老师：张仁坤 The The relationship between serum cardiac troponin I levels and the recent prognosis in unstable angina pectoris Abstract objective To investigate the relationship between serum cardiac troponin l(eTn—Il levels and the recent prognosis in unstable angina pectoris(UAP)． Methods Serum cTn—1 were measured in 38 UAP patients after admission and after 2—4hours、48hours and 72hours the incidences of cardiac events were observed．The peak value was used．The incidences of cardiac events were observed． Results(1)The cTn—I value displyed increased tandency along with exacerbation of Braunwald grade．rPO．01)(2)Among 42％of the 38 UAP patients(16 cases)cTn-I levels were increased．while the rest(22 cases)remained normal fO．31±0．33ng／ml VS O．033± 0．027n∥ml， respectively，P0．01)(3)The incidences of acute myocardial infarction(AMI)，sudden cardiac death and refractory angina pectoris within hospitalization period were significantly higher in patients with increased cTn-I level than the rest(45．2％VS 8．1％，P0．01)For cardiac events，the sensitivity was 81．8％and the specificity was 74．1％by serum cTn—I level；The positive and negative predictive value was 56．3％and 90．9％respectively(4)The relationship between cTn—I value and pathologic changes of coronary artery is unclear． Conclusion The present study indicates that the increase of the serum cTn-I level could predict the prognosis of patients with U