本文選題：急性心肌梗死　切入點：高敏肌鈣蛋白T　出處：《四川大學學報(醫(yī)學版)》2017年06期 　論文類型：期刊論文

【摘要】：目的基于四川地區(qū)大樣本健康人群,根據(jù)不同年齡及性別,建立高敏肌鈣蛋白T(hs-cTnT)第99百分位參考值,并通過回顧性研究驗證建立的參考值在胸痛患者中診斷急性心肌梗死(AMI)的價值。方法隨機挑選成都市8個獨立社區(qū)各個年齡段的志愿者,通過問卷調(diào)查記錄志愿者基本資料并進行體格、心電圖、超聲檢查等確定健康志愿者。采集血液分析hs-cTnT水平,按性別和年齡建立hs-cTnT第99百分位參考值。同時回顧性納入2009年7月至2014年7月四川大學華西醫(yī)院急診收治的胸痛患者2 249例,比較本次研究建立的參考值(14ng/L)與廠商所提供的參考值診斷急診胸痛患者發(fā)生AMI的靈敏度、特異度、陽性預測值和陰性預測值。結(jié)果共納入1 305例符合標準的健康志愿者,其中男性hs-cTnT水平為4.3(3.2~5.9)ng/L,高于女性3.0(3.0~3.1)ng/L,差異有統(tǒng)計學意義(P0.01)。男性和女性年齡與hs-cTnT的相關系數(shù)分別為0.43和0.29(P0.01),呈正相關。45歲、45~60歲和≥60歲年齡段男性hs-cTnT第99百分位值分別為10.8ng/L、15.4ng/L和19.7ng/L,女性分別為4.6ng/L、8.9ng/L、18.8ng/L�；仡櫺约{入急診胸痛患者2 249例采用新確立的第99百分位值與14.0ng/L分別進行驗證,60歲以下人群,本研究建立的參考值和14.0ng/L比較其診斷價值無差異,60歲及以上人群,其診斷AMI的靈敏度和陰性預測值差異無統(tǒng)計學意義(P0.05),特異度和陽性預測值明顯提高(男性:0.67vs.0.56,0.83vs.0.79,P0.05;女性:0.75vs.0.68,0.74vs.0.69,P0.05)。結(jié)論 60歲以下中國四川地區(qū)人群hs-cTnT第99百分位參考值為14.0ng/L,60歲及以上人群為20.0ng/L。
[Abstract]:Objective to establish the 99th percentile reference value of Gao Min troponin TnT based on a large sample of healthy people in Sichuan province. A retrospective study was conducted to verify the value of the established reference value in the diagnosis of acute myocardial infarction (AMI) in patients with chest pain. Methods volunteers of all ages in 8 independent communities in Chengdu were randomly selected. The basic data of the volunteers were recorded by questionnaire, and the health, electrocardiogram and ultrasonic examination were carried out to determine the healthy volunteers. The blood samples were collected to analyze the hs-cTnT level. The 99th percentile reference value of hs-cTnT was established according to sex and age. From July 2009 to July 2014, 2 249 patients with chest pain were admitted to the emergency department of Huaxi Hospital, Sichuan University. The sensitivity, specificity, positive predictive value and negative predictive value of AMI in emergency chest pain patients were compared with the reference values provided by manufacturers. Among them, the hs-cTnT level of male was 4.3 / 3.2ng / L, which was higher than that of female's 3.0ng / L, and the difference was statistically significant (P 0.01). The correlation coefficient between male and female age and hs-cTnT was 0.43 and 0.29, respectively, and the positive correlation was 4560 years old and 鈮，

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