Noble J S, Reid A M, Jordan L V, Glen A C, Davidson J A
Department of Anaesthesia, Victoria Infirmary, Glasgow, UK.
Br J Anaesth. 1999 Jan;82(1):41-6. doi: 10.1093/bja/82.1.41.
Cardiac troponin I (cTnI) is a protein that is specific to heart muscle. Increased concentrations appear in serum after myocardial cell injury. cTnI was compared with creatinine kinase MB (CK MB), myoglobin and the 12-lead ECG for detection of myocardial injury in an unselected series of 109 medical and surgical ICU patients. Clinical observations and daily 12-lead ECG were recorded prospectively. Samples for cTnI, myoglobin and CK MB serum analysis were collected each day. Increased serum cTnI concentrations (> 0.1 microgram litre-1) were observed in 70.6% (n = 77) of the ICU group. Tachycardia, arrhythmia, hypotension and treatment with inotropic drugs were associated with higher concentrations. The standardized mortality ratio by APACHE III for the ICU sample was 0.98. All subjects in an unmatched control group of 98 medical unit emergency admissions without a primary cardiac diagnosis had serum cTnI concentrations < 0.1 microgram litre-1. We conclude that increased serum cTnI concentrations occur frequently in the ICU suggesting that there is a high incidence of cardiac injury in these patients.
心肌肌钙蛋白I（cTnI）是一种心肌特异性蛋白。心肌细胞损伤后，血清中其浓度会升高。在109例未经过筛选的内科和外科重症监护病房（ICU）患者中，对cTnI与肌酸激酶同工酶MB（CK MB）、肌红蛋白以及12导联心电图进行比较，以检测心肌损伤情况。前瞻性记录临床观察结果和每日12导联心电图。每天采集cTnI、肌红蛋白和CK MB血清分析样本。ICU组中70.6%（n = 77）的患者血清cTnI浓度升高（> 0.1微克/升）。心动过速、心律失常、低血压以及使用正性肌力药物治疗与较高浓度相关。ICU样本的APACHE III标准化死亡率为0.98。在98例无原发性心脏诊断的内科病房急诊入院患者组成的非匹配对照组中，所有受试者血清cTnI浓度均< 0.1微克/升。我们得出结论，ICU患者血清cTnI浓度升高很常见，提示这些患者心脏损伤发生率很高。
