摘要
目的 :研究床边肌钙蛋白 I(c Tn I)定性检测对急诊胸痛病人诊治的价值。方法 :12 5例无 ST段提高的急性胸痛病人 ,采用单克隆抗体感光技术行床边 c Tn I定性检测。受诊时及 4小时后各测一次 c Tn I,胸痛不足 2小时者在入院后 6小时复测第三次 ,保证胸痛 6小时内有一次血标本。且能将检测结果及时提供给值班医生。结果 :c Tn I阳性 40例 (32 % ) ,其中有 2 2例临床确诊急性心肌梗死。 48例不稳定心绞痛病人 ,c T-n I阳性 13例。随访 30天 ,发现 4例死亡 ,4例非致命性心肌梗死。提示 c Tn I是心性事件独立的有力预测因素。c Tn I阴性者心性事件率 1.2 %。结论 :床边心脏特异 c Tn I定性检测对急性冠脉综合征的早期心肌损害具有高度的敏感性 ,阴性结果心性事件发生率非常低 ,可以允许急诊胸痛病人早期出院。
Objective:To prospectively investigate the usefulness of bedside tests for the detection of cardiac troponin Ⅰ in the evaluation of patients with acute chest pain.Methods:In 125 consecutive patients who had had acute chest pain without ST segment elevation on their electrocardiograms,troponin I status(positive or negative) was determined at least twice by sensitive, qualitative bedside tests based on the use of specific monoclonal antibodies.Testing was performed on arrival and four or more hours later so that one sample was taken at least six hours after the onset of pain. The troponin I results were made available to the treating physicians.Results:Troponin Ⅰ tests were positive in 40 patients(32%). Among 22 patients with evolving myocardial infarction,troponin Ⅰ tests were positive in all. Among 48 patients with unstable angina,troponin Ⅰ tests were positive in 13 patients(27%). During 30 days of follow up, there were 4 deaths and 4 nonfatal myocardial infarctions. Troponin Ⅰ proved to be strong, independent predictors of cardiac events. The event rates in patients with negative tests were only 1.2 percent for troponin Ⅰ.Conclusion:Bedside tests for cardiac specific troponin Ⅰ are highly sensitive for the early detection of myocardial cell injury in acute coronary syndrome. Negative test results are associated with low risk and allow rapid and safe discharge of patients with an episode of acute chest pain from the emergency room.[FK(WB80011。6]
出处
《温州医学院学报》
CAS
2000年第3期212-214,共3页
Journal of Wenzhou Medical College
