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目的通过对入院24 h完成血cTnⅠ检测的低水平升高患者的诊断分析,了解cTnⅠ低水平升高的临床诊断价值。方法统计分析近1.5年住院的发病24 h内的患者进行血cT-nI检测,血cTnI>0.1μg.L-1的1 019例患者,分成N1组(0.1μg.L-10.5μg.L-1)分析最终临床诊断情况。结果 N1组中13.8%、N2组中21.2%最终诊断为AMI,N3组中98.7%最终诊断为AMI。N1组和N2组的患者中心力衰竭占38.0%。结论 cTnI以两种形式存在于心肌细胞内,成人的骨骼肌组织在任何阶段都不表达cTnI,也不因任何病理刺激表达cTnI,目前cTnI被认为是最具心脏特异性最有价值的心肌损伤指标。cTnI明显升高时可以支持诊断AMI。心力衰竭、感染性疾病、多器官损伤、重度中毒患者等危重病时均可以有cTnI低水平升高,往往提示并有心肌损伤。
OBJECTIVE: To evaluate the diagnostic value of low level of cTnI in patients with low level of serum cTnI at 24 hours after admission. Methods A total of 1019 patients with blood cTnI> 0.1μg.L-1 were divided into N1 group (0.1μg.L-1 0.5 μg.L-1). The final clinical diagnosis was analyzed. Results 13.8% in N1 group, 21.2% in N2 group were diagnosed as AMI, and 98.7% in N3 group was diagnosed as AMI. Patients in group N1 and group N2 had 38.0% of patients with heart failure. Conclusions cTnI exists in two forms of cardiomyocytes. Adult skeletal muscle tissue does not express cTnI at any stage and cTnI is not induced by any pathological changes. Currently, cTnI is considered as the most cardio-specific and most valuable myocardial injury index. Significantly elevated cTnI can support the diagnosis of AMI. Heart failure, infectious diseases, multiple organ damage, severe poisoning and other critically ill patients may have low levels of cTnI, often prompted and myocardial injury.