Sukonthasarn Apichard, Ponglopisit Sumeth
Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2007 Sep;90(9):1749-58.
To find the diagnostic level and rising pattern of cardiac troponin T (cTnT) in patients with chronic renal dysfunction presented with acute myocardial infarction (AMI).
A pilot, cross-sectional study to compare the level of cTnT in adult patients with chronic renal dysfunction who were admitted and later confirmed to have AMI with those in the age and sex-matched controls with chronic renal dysfunction and non-coronary diagnosis.
Twenty-three patients were enrolled into each group. The mean cTnT levels in the AMI group were significantly higher than in the control group. Magnitude and rate of post-admission rise of cTnT were not significantly different between both groups. The diagnostic level of cTnT for AMI was 0.1 nanogram per milliliter with 90.90% sensitivity and 84.50% specificity. The sensitivity and specificity of this diagnostic level were 91.30% and 100.00% respectively when patients with chronic renal replacement were excluded.
The level ofcTnT of at least 0.1 nanogram per milliliter within the first 24 hours of admission was diagnostic for AMI in patients with chronic renal dysfunction. The sensitivity and specificity of the tests were better if the patients with chronic renal replacement were excluded.
探寻慢性肾功能不全合并急性心肌梗死（AMI）患者心肌肌钙蛋白T（cTnT）的诊断水平及升高模式。
一项前瞻性横断面研究，比较确诊为AMI的慢性肾功能不全成年患者与年龄及性别匹配的慢性肾功能不全且无冠心病诊断的对照组患者的cTnT水平。
每组纳入23例患者。AMI组的平均cTnT水平显著高于对照组。两组入院后cTnT升高的幅度和速率无显著差异。cTnT对AMI的诊断水平为0.1纳克/毫升，敏感性为90.90%，特异性为84.50%。排除接受慢性肾脏替代治疗的患者后，该诊断水平的敏感性和特异性分别为91.30%和100.00%。
入院后24小时内cTnT水平至少达到0.1纳克/毫升可诊断慢性肾功能不全患者的AMI。排除接受慢性肾脏替代治疗的患者后，检测的敏感性和特异性更佳。
