血清心肌肌钙蛋白 I 水平在肺栓塞中的意义。
Significance of serum cardiac troponin I levels in pulmonary embolism.
机构信息
Nafiz Kurt Bafra Public Hospital, Department of Chest Diseases, Samsun, Turkey;
出版信息
J Thorac Dis. 2012 Dec;4(6):588-93. doi: 10.3978/j.issn.2072-1439.2012.10.13.
BACKGROUND
Some biomarkers can be helpful in the diagnosis of pulmonary embolism (PE) and determining of severity and prognosis of the disease. In this study, we aimed to analyze the elevated cardiac troponin I (cTnI) levels and its association with electrocardiography (ECG) and transthoracic echocardiography (TTE) findings in patients with PE.
METHODS
Totally 106 patients with suspected PE were included in the study. PE was confirmed in 63 of them, whereas it was excluded in the remaining 43 patients. Levels of cTnI were measured in all patients before the prescription of the anticoagulation therapy.
RESULTS
High cTnI levels were found in 50.8% of patients with PE, and in 11.6% of patients without PE (P<0.001). Sensitivity and specificity of the test for the diagnosis of PE were 50.7%, 88.3% respectively. ECG findings were similar in PE patients having either elevated or normal cTnI levels. Approximately 75% of the PE patients with high cTnI had normal ECG findings; the most common pathological changes seen in ECG were S1Q3T3 pattern (31%). TTE findings were not found to be distinguishing in the patients with suspected PE and high cTnI levels. Pulmonary hypertension (PHT) was the most common echocardiographic finding (74%) in patients with PE and elevated cTnI levels. However, there was not a statistically significant difference between TTE findings in PE patients with increased and normal cTnI levels.
CONCLUSIONS
In patients presenting with clinical, electrocardiographic and echocardiographic features suggesting pulmonary embolism, increased serum cTnI levels endorse the diagnosis of severe PE.
背景
一些生物标志物有助于肺栓塞（PE）的诊断，并确定疾病的严重程度和预后。在这项研究中，我们旨在分析患有 PE 的患者中心脏肌钙蛋白 I（cTnI）水平升高及其与心电图（ECG）和经胸超声心动图（TTE）结果的关系。
方法
本研究共纳入 106 例疑似 PE 的患者。其中 63 例确诊为 PE，43 例排除。所有患者在开始抗凝治疗前均测量 cTnI 水平。
结果
PE 患者中 cTnI 水平升高者占 50.8%，PE 患者中 cTnI 水平正常者占 11.6%（P<0.001）。该试验对 PE 的诊断具有 50.7%的敏感性和 88.3%的特异性。cTnI 升高或正常的 PE 患者的心电图表现相似。约 75%的 cTnI 升高的 PE 患者心电图表现正常；心电图最常见的病理变化是 S1Q3T3 模式（约 31%）。在疑似 PE 且 cTnI 水平升高的患者中，TTE 发现没有区别。在 cTnI 升高的 PE 患者中，肺动脉高压（PHT）是最常见的超声心动图表现（约 74%）。然而，cTnI 升高和正常的 PE 患者的 TTE 发现之间没有统计学上的显著差异。
结论
在具有临床、心电图和超声心动图特征提示肺栓塞的患者中，血清 cTnI 水平升高支持严重 PE 的诊断。
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