肌钙蛋白I水平检测对急诊房颤患者的临床意义  

Clinical Utility and Prognostic Significance of Measuring Troponin I Levels in Patients Presenting to the Emergency Room with Atrial Fibrillation

作　　者：古升[1] 卢冰[2] 陈韩[3] 王俏梅[1] 陈海云[4] 

机构地区：[1]海南省人民医院检验科,海南海口570311 [2]海南省人民医院医疗保健中心三区检验科,海南海口570311 [3]海南医学院附属医院检验科,海南海口570311 [4]海南省疾病预防控制中心检验科,海南海口570311

出　　处：《现代生物医学进展》2015年第32期6325-6327,6370,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81260367)

摘　　要：目的:探讨房颤患者急诊入院时检测肌钙蛋白I(Tn I)水平的临床作用及预测价值。方法:回顾性分析我院523例房颤患者的临床资料,将资料中数据进行统计学分析处理。患者分为三组:1组患者Tn I轻度升高;2组患者Tn I正常;3组患者未检测Tn I,分别就三组患者的基线特征以及就诊时的症状展开数据比较,并且单变量及多变量分析Tn I升高的预测因子。设置主要终点为1年内所有原因导致的死亡及心肌梗死(MI),患者从入院时起随访1年,记录期间的MI发生情况及死亡情况。结果:173例患者(33%)Tn I轻度升高(均值0.56 ng/m L),225例患者(43%)Tn I正常,125例患者(24%)未检测Tn I。住院期间1组患者(50%)的心功能检查异常明显高于组2和组3(28%和29%,P≤0.001),1组患者(22%)主要终点发生率明显高于2组(10%)和3组患者(15%)(P=0.002),有统计学意义。结论:肌钙蛋白I轻度升高与冠脉疾病(CAD)发生率增加及MI发生率增加有关,但对于总体死亡率无影响。Objective： To assess the clinical utility and prognostic significance of measuring troponin I （TnI） levels in patients presenting to the emergency room with atrial fibrillation. Methods： The clinical data of 523 patients with atrial fibrillation were analyzed retrospectively, and processed statistically. Patients were divided into three groups, 1 group of patients with mild increase of TnI; 2 group of patients with normal Tnl; 3 group of patients were not detected TnI. The baseline characteristics and symptoms of the three groups of patients were compared and the predictors of elevated TnI were evaluated by single variable and multi variable analysis. The primary endpoint was death and myocardial infarction （MI） in 1 year. Patients were followed up from hospital for 1 year, and the occurrence of MI and death of the patients during the period was recorded. Results： The level of TnI was elevated in 173 patients （33 %, group 1; mean, 0.56 ng/mL）, normal in 225 patients （43 %, group 2）, and not measured in 125 patients （24 %, group 3）. Significantly more cardiac testing was done at index hospitalization in group 1 （50 %） compared with groups 2 and 3 （28 % and 29 %, P 〈 0.001）. The patients in group 1 had a significantly higher occurrence of the primary endpoint compared with the other two groups （22 %, vs 10 % and 15 %, P = 0.002）. Conclusions： Mild elevated TnI is associated with a greater incidence of coronary artery disease and a higher incidence of MI, but it has no effect on overall mortality.

关 键 词：房颤 肌钙蛋白I 心肌梗死 冠脉疾病 

分 类 号：R542.22[医药卫生—心血管疾病] R541.75[医药卫生—内科学]