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目的 :评价无ST段抬高的急性冠脉综合征 (ACS)患者病初血心脏肌钙蛋白I(cTnI)水平和死亡、透壁心肌梗死、冠脉搭桥术及血管成形术之间的关系。方法 :入选 10 1例患者 ,年龄 3 2～ 78岁 ,在胸痛发作后 2 4h内住院。 69例( 68 3 % )不稳定心绞痛和 3 2例 ( 3 1 7% )无ST节段抬高的心肌梗死患者。通过免疫学分析测量cTnI ,其值在 0 4ng/ml以下认为是正常。结果 :第 1组 45例cTnI水平升高 ,住院 3 0d内 16例 ( 3 5 5 % )有不利结局 ;第 2组 5 6例cTnI值正常 ,其中 5例有不利结局 ( 8 9% ;P =0 0 0 1)。 6个月时第 1组和第 2组患者分别有 19例 ( 4 2 2 % )和 6例 ( 10 7% )患者发生事件 (P =0 0 0 0 4)。结论 :无ST节段抬高的ACS患者的血cTnI水平升高对预后有重要价值
PURPOSE: To evaluate the relationship between initial cardiac troponin I (cTnI) levels and death, transmural myocardial infarction, coronary artery bypass grafting and angioplasty in patients with ST-elevation acute coronary syndrome (ACS) . Methods: A total of 101 patients were enrolled, aged 32 to 78 years and hospitalized within 24 hours after the onset of chest pain. 69 patients (68.3%) with unstable angina pectoris and 32 (31.7%) patients with ST-segment elevation myocardial infarction. CTnI was measured by immunological analysis and its value below 0 4 ng / ml was considered normal. Results: The cTnI level was increased in 45 cases in group 1, and 16 cases (35.5%) in hospitalized 30 days had adverse outcomes. In group 2, 56 cases had normal cTnI values, of which 5 cases had adverse outcomes (8 9%; P = 0 0 0 1). At 6 months, 19 (42.2%) and 6 (107%) patients in Groups 1 and 2, respectively, had an event (P = 0.00004). CONCLUSIONS: Elevated blood levels of cTnI in patients with ACS without ST segment elevation are important prognostic factors