【摘要】 目的探讨肌钙蛋白(troponinI,TnI)、肌红蛋白(myoglobin,Mb)对非ST段抬高急性冠状动脉综合征病人预后的预测价值。方法因急性胸痛拟诊非ST段抬高急性冠状动脉综合征病人而连续收入院的120例病人,入院后仔细询问病史、检查体格,并在10min内完成常规12导联心电图检查,同时测定静脉血TnI、Mb。以血TnI1.0μg/L将病人分成TnI阳性组和TnI阴性组;Mb70μg/L分为Mb阳性组和阴性组。随访各组6个月主要心血管事件发生率。结果TnI阳性组及Mb阳性组的随访期因反复心绞痛住院及复合心管事件显著增多。多因素Logistic回归分析显示,TnI阳性较Mb阳性及ST段压低因素对病人随访期复合心血管事件有独立预测价值。结论TnI及Mb水平对非ST段抬高ACS病人的危险分层及心血管事件预测有重要价值。更多还原

【Abstract】 Objectives To investigate the prognostic significance of serum cardiac troponin I (TnI) and myoglobin(Mb) in patients with non-ST elevation acute coronary syndromes(ACS). Methods 120 patients with acute chest pain were admitted to hospital consecutively with the diagnosis of non-ST elevation ACS from January 2003 to January 2005. The case history was collected and the physical examination and 12 leads of ECG test within 10 min after hospitalization were performed. Meanwhile, TnI and Mb were determined at bedside. All patients were divided into TnI-positive group(TnI≥1.0 μg/L) and TnI-negative group(TnI<1.0 μg/L) according to TnI level, and the patients were re-divided into Mb-positive group(Mb≥70 μg/L) and Mb-negative group(Mb<70 μg/L) according to Mb level. The major adverse cardiovascular events were analyzed in each group in follow-up period. Results The incidences of recurrent angina and combined cardiovascular events during the follow-up period increased more significantly in TnI-positive group than that in TnI-negative group. Meanwhile, recurrent angina and combined cardiovascular events were higher in Mb-positive group. Multivariable logistic regression analysis revealed that TnI-positive was of higher independently prediction value for combined cardiovascular events at follow-up than ST depression and Mb-positive. Conclusions The levels of TnI and Mb play an important role on risk stratification and prediction of cardiovascular events in patients with non-ST elevation ACS.更多还原