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目的探讨入院时心肌肌钙蛋白I(cTnI)水平在急性心肌梗死(AMI)患者诊断与预测预后中的价值。方法对143例AMI患者检测入院时cTnI水平,分析入院前不同病程患者cTnI阳性检出率,并观察其住院期间及随访3~12月内主要心血管事件(MACE)发生率。结果发病6 h~8 d入院者cTnI阳性率达98.9%。入院时cTnI≥52.5μg/L的患者住院期间心脏性死亡率明显升高(P<0.01)。cTnI阳性组住院期间心脏性死亡、总的心脏性死亡及总的MACE发生率较阴性组明显升高(P<0.01)。单纯药物治疗者cTnI阳性组MACE发生率明显高于cTnI阴性组(P<0.05),而急诊支架、药物溶栓、延期支架治疗者MACE发生率cTnI阳性和阴性组间无差异(P>0.05)。结论入院时cTnI水平是AMI诊断的重要依据;入院时cTnI水平与MACE发生率密切相关;入院时cTnI≥52.5μg/L、cTnI阳性且年龄≥70岁患者为高危人群;早期再灌注治疗可改善预后。
Objective To investigate the value of cardiac troponin I (cTnI) levels in the diagnosis and prognosis of patients with acute myocardial infarction (AMI) on admission. Methods The levels of cTnI in 143 AMI patients were detected. The positive rate of cTnI was analyzed before admission and the incidence of major cardiovascular events (MACE) within 3 to 12 months of follow-up was observed. Results The incidence of cTnI positive rate was 98.9% in patients admitted from 6 h to 8 d. Cardiac mortality was significantly higher in hospitalized patients with cTnI ≥ 52.5 μg / L (P <0.01). Cardiac death, total cardiac death and total MACE were significantly higher in the cTnI-positive group than in the negative group (P <0.01). The incidence of MACE in cTnI positive patients in simple drug treatment group was significantly higher than that in cTnI negative patients (P <0.05), while there was no difference in the incidence of MACE between cTnI positive patients and acute rejection patients (P> 0.05) . Conclusions The level of cTnI on admission is an important basis for the diagnosis of AMI. The level of cTnI on admission is closely related to the incidence of MACE. On admission, cTnI≥52.5μg / L, cTnI positive and age ≥70 years old are at high risk. The early reperfusion therapy can be improved Prognosis.