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題 名 | Serial Changes of Cardiac Troponin-I in Acute Myoischemia Induced by Exercise Treadmill Test=運動心電圖誘發心肌缺氧之心肌旋轉蛋白酶-I的改變 |
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作 者 | 李坤泰; 賴文德; 陳韋任; 許勝雄; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 17:5 2001.05[民90.05] |
頁 次 | 頁239-244 |
分類號 | 415.3165 |
關鍵詞 | 運動心電圖; 心肌缺氧; 心肌旋轉蛋白酶-I; Cardiac troponin-I; Angina; Treadmill exercise test; |
語 文 | 英文(English) |
中文摘要 | 心肌旋轉蛋白-I的測定,對於急性心肌梗塞的診斷,有很高的敏感性 及特異性。然而,有些不穩定心絞痛的病人,他們的心肌旋轉蛋白-I也有升高的 現象。而且,這類病人的預後,比心肌旋轉蛋白-I沒有升高的病人要來的不好。 本篇研究的目的,是要了解穩定型心絞痛的病人,藉由運動心電圖誘發心肌缺 氧,是否也會引起心肌旋轉蛋白-I的升高。共有35位疑是冠狀動脈疾病的病人 及5位醫學生自願加入本次研究。每人均作運動心電圖。分別於運動心電圖前及 運動心電圖後的5分鐘、1小時、3小時、6小時共5個時段抽血,以螢光免疫 分析法測定心肌旋轉蛋白-I值。其中心肌旋轉蛋白-I值正常應小於0.5ng/ml,而 診斷急性心肌梗塞,心肌旋轉蛋白-I值應大於2.0 ng/ml。結果35位病人中,有 19位運動心電圖為陽性,而16位病人及5位醫學生運動心電圖為陰性。在19 位運動心電圖陽性病人中,有7位病人的心肌旋轉蛋白-I值在不同的時段有不正 常升高,但都小於2.0 ng/ml (平均為1.1±0.4ng/ml)。而21位運動心電圖陰性中, 只有1位病人的心肌旋轉蛋白-I有不正常升高,其值也小於2.0ng/ml,這位病人 由冠狀動脈攝影證實為冠狀動脈疾病(2條血管)。故由本研究顯示,在穩定型 心絞痛的病人,藉由運動心電圖誘發心肌缺氧,有可能使心肌旋轉蛋白-I值升 高,且其值不似急性心肌梗塞時一般高。 |
英文摘要 | Cardiac troponin-I (cTn-I) is a sensitive and specific marker for the diagnosis of acute myocardial infarction (AMI). However, elevation of serum cTn-I has been observed in some unstable angina patients who have a worse prognosis than those with normal serum cTn-I levels. It is unknown whether serum cTn-I can elevate in stable angina patients with acute ischemic burden. Therefore, the purpose of this study was to determine a serial change of cTn-I in patients with acute ischemia induced by a treadmill exercise test. Thirty-five patients suspected of having coronary artery disease and five healthy medical students were enrolled into this study. Every patient received a treadmill exercise test. Cardiac troponin-I was measured by fluorescent immunoassay before the treadmill test and at 5 minutes, 1 hour, 3 hours, and 6 hours after the treadmill test. Patients with cTn-I levels of less than 0.5 ng/ml were considered normal, and those with cTn-I levels of greater than 2.0 ng/ml was considered to have AMI. The exercise test was positive in 19 of the 35 patients and negative in 16 of the 35 patients and 5 medical students. Among the 19 patients with positive treadmill exercise test, the cTn-I concentrations were abnormally increased in 7/19 (37%) patients (mean: 1.1?.4 ng/ml ; range: 0.5 to 2.0 ng/ml). One of the 16 patients with negative treadmill test showed an increase of serum cTn-I. Normal cTn-I levels were found in the other 15 patients and the 5 medical students. In conclusion, serum cTn-I levels were found to increase to some extent in one third of stable angina patients who have an acute ischemic episode induced by treadmill exercise test. |
本系統中英文摘要資訊取自各篇刊載內容。