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目的探讨血清心肌肌钙蛋白I(cTnI)水平与冠心病患者远期心脏事件的相关性。方法测定169例冠心病患者的血清cTnI、肌酸激酶同功酶(CK-MB),根据cTnI水平将患者分为cTnI正常组和升高组,列出患者一般临床资料、冠脉造影及心电图结果,随访患者远期心脏事件,分析cTnI与远期心脏事件的相关性。结果169例患者中有59例cTnI升高(34.9%);cTnI升高与心电图异常Q波、ST段改变呈正相关(P<0.05),与糖尿病呈负相关(P<0.05)。162例近期生存者中152例有远期随访结果,随访率为93.8%,随访时间为(26±10)个月,共有27例患者发生32件远期心脏事件,其发生与女性患者、cTnI升高呈正相关(P<0.05);多因素非条件Logistic回归分析排除混杂因素的影响,cTnI升高与cTnI正常患者的远期心脏事件发生率及人均心脏事件差异有统计学意义(P<0.05)。结论cTnI是心肌损伤敏感而特异性的指标,血清cTnI水平是冠心病患者远期心脏事件的独立预测因子。
Objective To investigate the relationship between serum cardiac troponin I (cTnI) and long-term cardiac events in patients with coronary heart disease. Methods Serum cTnI and creatine kinase isoenzyme (CK-MB) were measured in 169 patients with coronary heart disease. According to cTnI level, patients were divided into normal cTnI group and elevated group. The clinical data, coronary angiography and electrocardiogram Results, follow-up of patients with long-term cardiac events, analysis of cTnI and long-term cardiac events. Results The 59 patients with cTnI increased in 59 (34.9%). Elevated cTnI was positively correlated with Q wave and ST segment abnormalities (P <0.05) and negatively correlated with diabetes (P <0.05). Of the 162 recent survivors, 152 had long-term follow-up results, with a follow-up rate of 93.8% and a follow-up time of (26 ± 10) months. A total of 32 patients with long-term cardiac events occurred in 27 patients, which occurred in women with cTnI (P <0.05). Multivariate non-conditional logistic regression analysis excluded the influence of confounding factors. The increase of cTnI and the incidence of long-term cardiac events and per capita cardiac events in normal cTnI patients were statistically significant (P <0.05 ). Conclusions cTnI is a sensitive and specific indicator of myocardial injury. Serum cTnI level is an independent predictor of long-term cardiac events in patients with coronary heart disease.