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目的探讨肌钙蛋白I(cTnI)曲线对不稳定型心绞痛(UA)危险分层的临床价值。方法用酶联免疫法测定136例UA患者入院即刻、2、4、6、8、24、48、72小时血cTnI水平并绘制cTnI曲线,根据曲线类型分为有峰曲线组和水平曲线组;比较住院期间和半年后两组心绞痛、急性心肌梗死(AMI)、左室射血分数、心源性死亡的发生率。结果136例UA患者中有峰曲线组67例,水平曲线组69例。有峰曲线组与水平曲线组比较,住院期间心绞痛反复发作、AMI、左室射血分数,P<0.05;无血管重建6个月后心绞痛复发、再发AMI、心源性死亡、左室射血分数有峰曲线组与水平曲线组比较,P<0.05;血管重建6个月后心绞痛复发、再发AMI、心脏性死亡、左室射血分数有峰曲线组与水平曲线组比较,P≥0.05。结论cTnI曲线能评估UA患者的近期预后和指导治疗,可作为UA危险分层指标之一。
Objective To investigate the clinical value of cTnI curve in risk stratification of unstable angina pectoris (UA). Methods The level of cTnI in 136 UA patients admitted to hospital immediately, 2, 4, 6, 8, 24, 48, and 72 hours after the hospital admission was measured by enzyme-linked immunosorbent assay and cTnI curves were drawn. According to the curve types, they were divided into peak curve group and horizontal curve group; The incidences of angina pectoris, acute myocardial infarction (AMI), left ventricular ejection fraction, and cardiac death were compared between the two groups during hospitalization and six months later. Results There were 67 cases of peak curve group and 69 cases of horizontal curve group in 136 UA patients. The peak curve group and the horizontal curve group, recurrent angina during hospitalization, AMI, left ventricular ejection fraction, P <0.05; angina recurrence 6 months after revascularization, recurrent AMI, cardiac death, left ventricular ejection P <0.05. The angina recurrence occurred 6 months after revascularization, and AMI, cardiac death, left ventricular ejection fraction peak curve group compared with the level of curve group, P≥ 0.05. Conclusions The cTnI curve can assess the short-term prognosis and guide therapy of UA patients, which can be used as one of the risk stratification indicators of UA.