急诊科胸痛患者肌钙蛋白 I 灰区的临床意义：一项回顾性初步研究。
Clinical significance of initial troponin I in the grey zone in emergency department chest pain patients: a retrospective pilot study.
机构信息
Department of Emergency Medicine, Western Health, Footscray, Australia.
出版信息
Emerg Med J. 2010 Apr;27(4):302-4. doi: 10.1136/emj.2009.077669.
AIM
'Normal' range for cardiac troponin I (TnI) has changed with more sensitive tests, but the validity of low-level elevations is contentious. We aimed to describe the characteristics and outcome of patients with an initial TnI level 1-5 times the upper limit of normal.
METHODS
Retrospective study of patients assessed for ACS with initial TnI level between 0.05-0.19 ng/ml. Data collected included demographics, clinical data, TnI levels and outcome. Primary outcome was the proportion of patients who had a serial TnI rise consistent with ACS.
RESULTS
72 patients were studied; median age 71, median TIMI score 3, 66.7% male. 35 patients (48.6%) had a TnI rise consistent with ACS.
CONCLUSION
Approximately half of patients with initial TnI between 0.05-0.19 ng/ml had a TnI rise consistent with ACS. An initial TnI in this range is not, of itself, indicative of ACS. Clinical decision-making should be guided by clinical features and serial TnI measurement.
目的
随着更敏感的检测方法的出现，心肌肌钙蛋白 I（TnI）的“正常”范围已经发生了变化，但低水平升高的有效性仍存在争议。本研究旨在描述初始 TnI 水平高于正常上限 1-5 倍的患者的特征和结局。
方法
回顾性研究了初始 TnI 水平在 0.05-0.19ng/ml 之间的 ACS 患者。收集的数据包括人口统计学、临床数据、TnI 水平和结局。主要结局是具有与 ACS 一致的连续 TnI 升高的患者比例。
结果
共研究了 72 名患者，中位年龄为 71 岁，中位 TIMI 评分 3 分，66.7%为男性。35 名患者（48.6%）的 TnI 升高与 ACS 一致。
结论
初始 TnI 在 0.05-0.19ng/ml 之间的患者中，约有一半的患者具有与 ACS 一致的 TnI 升高。该范围内的初始 TnI 本身并不能提示 ACS。临床决策应根据临床特征和连续 TnI 测量来指导。
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