Serial Changes of Cardiac Troponin-I in Acute Myoischemia Induced by Exercise Treadmill Test

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2.0ng/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值不同的時段有不正常升高，但都小於2.0ng/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。

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並列摘要

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±0.4 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 Ode third of stable angina patients who have an acute ischemic episode induced by treadmill exercise test.

並列關鍵字

cardiac troponin-I ； angina ； treadmill exercise test

國際替代計量

Serial Changes of Cardiac Troponin-I in Acute Myoischemia Induced by Exercise Treadmill Test

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