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目的观察肌钙蛋白I(TnI)对非ST段抬高急性冠状动脉综合征(NSTEACS)低分子肝素抗凝疗效的预测价值。方法起病后24h内就诊住院的160例NSTEACS患者,TnI阳性者或阴性者分别随机分为治疗组和对照组,治疗组予以常规治疗加低分子肝素钙,对照组仅接受常规治疗。随访30d和6个月,观察终点为心血管事件(包括心脏性死亡、非致命性心肌梗死、非致命性心力衰竭、因反复心绞痛发作住院)发生率。结果随访30d和6个月时分别与对照组比较,TnI阳性治疗组患者因反复心绞痛住院及复合心血管事件发生率均显著降低(P<0.05)。而TnI阴性患者中治疗组与对照组无显著性差异。结论早期低分子肝素干预治疗能减少TnI阳性NSTEACS患者随访期内心血管事件的发生,但不能使TnI阴性患者从中受益。
Objective To investigate the predictive value of troponin I (TnI) in the anticoagulation of non-ST-elevation acute coronary syndrome (NSTEACS) low molecular weight heparin. Methods Totally 160 patients with NSTEACS hospitalized with TnI positive or negative were randomly divided into treatment group and control group. The treatment group received routine treatment plus low molecular weight heparin calcium, and the control group received only routine treatment. At the end of follow-up of 30 days and 6 months, the incidence of cardiovascular events (including cardiac death, non-fatal myocardial infarction, non-fatal heart failure and hospitalizations due to recurrent angina pectoris) was observed. Results Compared with the control group, the incidence of hospitalized patients with recurrent angina pectoris and composite cardiovascular events in the TnI-positive group were significantly decreased at 30 days and 6 months after follow-up (P <0.05). The TnI-negative patients in the treatment group and the control group no significant difference. Conclusion The early treatment with low molecular weight heparin can reduce the incidence of cardiovascular events during the follow-up of TnI-positive NSTEACS patients, but can not benefit TnI-negative patients.