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目的 评价心肌肌钙蛋白T (cTnT)与肌酸激酶同工酶 MB (CK MB)蛋白量在胸痛危险分层中的作用。方法 对所有病例进行 12h床边动态监测 ,包括基线、 4、 8、 12h的连续心律监测和 12导联心电图 (ECG)测试 ;与此同时分别于基线、 4、 8、 12h对入选胸痛组的其中 383例患者测定cTnT、CK -MB。结果 383例CPU患者只有 8例 (2 1% )CK -MB阳性 ,39例cTnT阳性。cTnT状态与随访的结果表明 ,cTnT阳性明显早于CK MB。 89%cTnT阳性患者血管造影术显示发生冠状动脉疾病 (CAD)及多支血管病。结论 cTnT比CK MB在评估伴心肌坏死和多支血管病的胸痛危险分层中具有更高的敏感性与特异性 ;常规测定cTnT更便于胸痛的危险分层与处理
Objective To evaluate the role of cardiac troponin T (cTnT) and creatine kinase MB (CK MB) levels in the risk stratification of chest pain. Methods 12h bedside dynamic monitoring including baseline, 4,8,12h continuous heart rate monitoring and 12-lead electrocardiogram (ECG) test was performed in all cases. At the same time, the patients were also enrolled in the chest pain group at 4, 8 and 12 hours 383 patients were measured cTnT, CK-MB. Results Of the 383 patients with CPU, only 8 (21%) had positive CK-MB and 39 had cTnT positive. Results of cTnT status and follow-up showed that cTnT positive was significantly earlier than CK MB. Angiography of 89% of cTnT-positive patients showed coronary artery disease (CAD) and multivessel disease. Conclusions cTnT is more sensitive and specific than CK MB in assessing the risk stratification of chest pain with myocardial necrosis and multivessel disease. Conventional measurement of cTnT facilitates risk stratification and management of chest pain