高敏肌钙蛋白Ⅰ浓度低于健康人群99百分位的非急性心肌梗死急诊胸痛患者的性别年龄调查  

The age and sex differences of non acute myocardial infarction patients who presented with chest pain with hs-cTnI levels below the 99th percentile upper reference limit

作　　者：王尧城 赖力[1,2] 林赛梅[1,2] 陈点[1,2] 韩莉莉[1,2] 余鸿[1,2] 刘尚龙[1,2] 沈晓丽 WANG Yao-cheng;LAI Li;LIN Sai-mei;CHEN Dian;HAN Li-li;YU Hong;LIU Shang-long;SHEN Xiao-li(Fujian Provincial Key Laboratory of Cardiovascular Disease,Fuzhou,350001,China;Fujian Provincial Hospital Central Laboratory,Fuzhou,350001,China)

机构地区：[1]福建省心血管病重点实验室,福州350001 [2]福建省立医院中心实验室,福州350001

出　　处：《创伤与急诊电子杂志》2019年第4期212-217,共6页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的调查高敏肌钙蛋白Ⅰ(high-sensitivity cardiac troponin Ⅰ,hs-cTnI)浓度低于健康人群99百分位的非急性心肌梗死急诊胸痛患者的性别年龄差异。方法回顾性分析2018年1月至2019年5月于福建省立医院急诊就诊的非创伤性胸痛患者的临床资料,所有患者首次hs-cTnI浓度值低于健康人群99百分位(40ng/L)且最终均排除急性心肌梗死(acute myocardial infarction,AMI)诊断,共计5453例,分别依据性别、年龄及hs-cTnI浓度值进行分组,采用Mann-Whitney U检验、Kruskal-Wallis H检验和χ~2检验进行组间差异分析,并应用Spearman相关分析评估年龄和hs-cTnI之间的相关性。结果 5453例患者中男性hs-cTnI值7(1~13)ng/L较女性6(1~10)ng/L高(Z=4 069 881.50,P<0.05),且随年龄增长而显著升高(Z=766.18,P<0.05);在各个年龄组别中男女性别比例存在差异(χ~2=23.78,P<0.05),随年龄增长,男性占比显著增多;在各个hs-cTnI浓度组别中年龄分布(Z=979.11,P<0.05)及男女性别比例(χ~2=49.90,P<0.05)均存在差异,hs-cTnI浓度值较高的组年龄也越大。经Spearman相关分析,hs-cTnI与年龄(r=0.392,P<0.05)呈正相关。结论低于健康人群99百分位(40ng/L)的hs-cTnI浓度值在年龄和性别上有显著差异性,年龄与hs-cTnI浓度值之间也存在相关性。建议将低于健康人群99百分位hs-cTnI浓度用于急诊非创伤性胸痛患者早期分诊时,应考虑患者的年龄和性别,从而提高急诊非创伤性胸痛患者的分诊准确率。Objective To investigate the age and sex differences of non acute myocardial infarction patients presenting with chest pain and reported high-sensitivity troponin I(hs-cTnI)levels below the 99th percentile upper reference limit.Methods A retrospective study was conducted to collect 5453 emergency patients with non-traumatic chest pain who were treated in Fujian Provincial Hospital from January,2018 to May,2019.All patients underwent hscTnI testing at presentation with hs-cTnI values below the 99th percentile upper reference limit(≤40ng/L)and finally made the exclusion diagnosis of acute myocardial infarction(AMI).The data were grouped by age,gender and hs-cTnI values respectively.Then,comparison was performed using Mann-Whitney U test,Kruskal-Wallis H test and Chi-square test.The correlation between age and hs-cTnI was assessed by Spearman correlation analysis.Results The hs-cTnI value below the 99th percentile upper reference limit(≤40ng/L)was higher in men 7(1~13)ng/L than that in women 6(1~10)ng/L(Z=4069881.50,P<0.05)and increased with age(Z=766.18,P<0.05).The gender ratio among each age group was significant different(χ2=23.78,P<0.05).With the increase of age,the proportion of males increases significantly.Moreover,in each group divided in terms of hs-cTnI values,differences exist in age distribution(Z=979.11,P<0.05)and gender ratio(χ2=49.90,P<0.05).Spearman correlation analysis showed that hscTnI was positively correlated with age(r=0.392,P<0.05).Conclusion There were significant differences in the age and sex of patients with hs-cTnI values below the 99th percentile upper reference limit(≤40ng/L).In addition,there was a correlation between age and hs-cTnI values.It is suggested that the age and sex of patients should be taken into account when hs-cTnI is used in the early classification of emergency patients with non-traumatic chest pain,so as to reduce the misclassification of emergency patients with non-traumatic chest pain.

关 键 词：胸痛 健康人群99百分位 急性心肌梗死 性别 年龄 

分 类 号：R459.7[医药卫生—急诊医学]