肌鈣蛋白Ⅰ在急性心力衰竭鑒別診斷中的應用價值_《華西醫學》

作者：

核工業416醫院1心血管內科;2核醫學科,四川成都 610051;

關鍵詞：

急性心衰肌鈣蛋白Ⅰ 診斷和鑒別診斷

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目的:明確肌鈣蛋白Ⅰ(cTnI)在心源性呼吸困難的鑒別診斷中有無應用價值。方法:比較急性心衰與急性肺源性呼吸困難時cTnI的變化情況,并觀察一定的cTnI臨界值輔助診斷心衰的敏感性和特異性。結果:總共156例患者,最后確診為急性心衰的患者69例,而肺源性呼吸困難患者87例。急性心衰組的平均cTnI值為076±085ng/dL,而肺源性呼吸困難組為025±032ng/dL,兩組間有顯著性差異(P lt;0001)。根據ROC曲線計算肌鈣蛋白Ⅰ的臨界值(截點值)為042ng/dL,其鑒別心衰的敏感度為7153%,特異度為9036%,準確度為8014%。結論:檢測肌鈣蛋白Ⅰ水平并與其它臨床信息相結合,有助于快速準確地診斷充血性心力衰竭。

引用本文： 王華,陳啟,施凱奕,曾琳琳,張成偉,田培志. 肌鈣蛋白Ⅰ在急性心力衰竭鑒別診斷中的應用價值. 華西醫學, 2009, 24(5): 1119-1121. doi: 復制

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3.	MAISEL A S, KRISHNASWAMY P, NOWAK RM, et al. Rapid measurement of Btype natriuretic peptide in the emergency diagnosis of heart failure[J]. N Engl J Med,2002,347(3):161167.
4.	SAIKI A, IWASE M, TAKEICHI Y, et al. Diversity of the elevation of serum cardiac troponin Ⅰ levels in patients during their first visit to the emergency room[J]. Circ J,2007,71:14581462.
5.	ADAMS KF J R, FONAROW G C, EMERMAN C L, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States:rationale, design, and preliminary observations from the Acute Decompensated Heart Failure National Registry (ADHERE)[J]. Am Heart J,2005,149:209216.
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7.	ANGHELOIU G O, DICKERSON R P, RAVAKHAH K. Etiology of troponin Ⅰ elevation in patients with congestive heart failure and low clinical suspicion of myocardial infarction[J]. Resuscitation,2004,63:195201.
8.	LOWBEER C, GUSTAFSSON S A, SEEBERGER A, et al. Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction[J]. Scand J Clin Lab Invest,2004,64:667６76.
9.	MANN D L. Mechanisms and models in heart failure: a combinatorial approach[J]. Circulation,1999,100:9991008.
10.	PERNA E R, MACIN S M, CIMBARO CANELLA J P, et al. High levels of troponin T are associated with ventricular remodeling and adverse inhospital outcome in heart failure[J]. Med Sci Monit,2004,10:CR9095.
11.	YOU J J, AUSTIN P C, ALTER D A, et al. Relation between cardiac troponin Ⅰ and mortality in acute decompensated heart failure[J]. Am Heart J,2007,153:462470.

1. BALES A C, SORRENTINO M J. Causes of congestive heart failure: prompt diagnosis may affect prognosis[J]. Postgrad Med,1997,101:4449,5456.
2. DAO Q, KRISHNASWAMY P, KAZANEGRA R, et al. Utility of Btype natriuretic peptide in the diagnosis of congestive heart failure in an urgentcare setting[J]. J Am Coll Cardiol,2001,37:379385.
3. MAISEL A S, KRISHNASWAMY P, NOWAK RM, et al. Rapid measurement of Btype natriuretic peptide in the emergency diagnosis of heart failure[J]. N Engl J Med,2002,347(3):161167.
4. SAIKI A, IWASE M, TAKEICHI Y, et al. Diversity of the elevation of serum cardiac troponin Ⅰ levels in patients during their first visit to the emergency room[J]. Circ J,2007,71:14581462.
5. ADAMS KF J R, FONAROW G C, EMERMAN C L, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States:rationale, design, and preliminary observations from the Acute Decompensated Heart Failure National Registry (ADHERE)[J]. Am Heart J,2005,149:209216.
6. PEACOCK W F, MARCO T D, FONAROW G C, et al. Cardiac Troponin and outcome in acute heart failure[J]. N Engl J Med,2008,358:21172126.
7. ANGHELOIU G O, DICKERSON R P, RAVAKHAH K. Etiology of troponin Ⅰ elevation in patients with congestive heart failure and low clinical suspicion of myocardial infarction[J]. Resuscitation,2004,63:195201.
8. LOWBEER C, GUSTAFSSON S A, SEEBERGER A, et al. Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction[J]. Scand J Clin Lab Invest,2004,64:667６76.
9. MANN D L. Mechanisms and models in heart failure: a combinatorial approach[J]. Circulation,1999,100:9991008.
10. PERNA E R, MACIN S M, CIMBARO CANELLA J P, et al. High levels of troponin T are associated with ventricular remodeling and adverse inhospital outcome in heart failure[J]. Med Sci Monit,2004,10:CR9095.
11. YOU J J, AUSTIN P C, ALTER D A, et al. Relation between cardiac troponin Ⅰ and mortality in acute decompensated heart failure[J]. Am Heart J,2007,153:462470.

《華西醫學》

肌鈣蛋白Ⅰ在急性心力衰竭鑒別診斷中的應用價值

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《華西醫學》

肌鈣蛋白Ⅰ在急性心力衰竭鑒別診斷中的應用價值

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料