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| 1 | 重型颅脑损伤患者24h内检测心肌肌钙蛋白Ⅰ的临床意义探讨显示文摘目的:对重型颅脑损伤患者外伤24 h内检测心肌肌钙蛋白I(cardiac troponin I,c Tn I)并进行有关的临床观察和分析,探讨其与患者病情发展及预后的关系。方法:采用前瞻性研究方法对新入院的重型颅脑损伤患者外伤后24 h内检测血c Tn I,解读重型颅脑损伤患者c Tn I异常升高的发生率,格拉斯哥昏迷评分(GCS)高低与c Tn I的关系,c Tn I升高与颅脑损伤患者心血管事件发生率和死亡率的关系,c Tn I预测重型颅脑外伤患者死亡的统计学意义。结果:1重型颅脑损伤患者外伤后24 h内c Tn I异常升高率达25.6%(45/176);3例(7.7%)达0.04 ng/m L,其余正常;2 c Tn I异常升高患者更易发生心血管事件:心电图异常,超声心动图异常,N-末端B型利钠肽原(NT-pro BNP)>300 ng/L;3住院期间共死亡47例(26.7%),主要死亡原因为心跳呼吸骤停、多器官功能衰竭和心功能衰竭;4如c Tn I>0.4 ng/m L,预测敏感度为36.2%、特异度达97.7%、阳性预测值达85.0%且假阳性情况很少;如c Tn I测定值超过1.0 ng/m L,则患者全部预后不良。结论:重型颅脑损伤患者外伤24 h内血c Tn I异常升高者其颅脑损伤程度更重并容易发生心血管事件和死亡,可作为损伤严重度分层及死亡预测指标;该型患者c Tn I异常可能主要出现于外伤早期阶段,其异常升高的机制不清,可能与其他疾病如蛛网膜出血不同。 | 殷乐 邱祖红 陈建军 季勇 | 2015 | 南京医科大学学报(自然科学版)2015，35，8： | 11 |
| 2 | Typical rise and fall of troponin in(peri-procedural) myocardial infarction:A systematic review显示文摘AIM: To identify the typical shape of the rise and fall curve of troponin(Tn) following the different types of myocardial infarction(MI). METHODS: We conducted a systematic search in PubM ed and Embase including all studies which focused on the kinetics of Tn in MI type 1, type 4 and type 5. Tn levels were standardized using the 99 th percentile, a pooled mean with 95%CI was calculated from the weighted means for each time point until 72 h. RESULTS: A total of 34 of the 2528 studies identified in the systematic search were included. The maximum peak level of the Tn was seen after 6 h after successful reperfusion of an acute MI, after 12 h for type 1 MI and after 72 h for type 5 MI. In type 1 MI there were additional smaller peaks at 1 h and at 24 h. After successful reperfusion of an acute MI there was a second peak at 24 h. There was not enough data available to analyze the Tn release after MI associated with percutaneous coronary intervention(type 4).CONCLUSION: The typical rise and fall of Tn is different for type 1 MI, successful reperfusion of an acute MI and type 5 MI, with different timing of the peak levels and different slopes of the fall phase. | Dianne van Beek Bas van Zaane Marjolein Looije Linda Peelen Wilton van Klei | 2016 | World Journal of Cardiology2016，8，3： | 1 |
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