玉溪地区高敏肌钙蛋白T在人群中的分布特点分析
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摘要
目的了解玉溪地区高敏肌钙蛋白T(high sensitive cardiac troponin-T,hs-cTnT)在普通人群中的分布特点。方法以玉溪市人民医院2017年7月至10月的1 594例18～89岁健康体检者为研究样本,对hs-cTnT在普通健康人群检出率、分布特点及与常规生化指标的相关性进行统计分析。结果 (1)hs-cTnT在普通健康人群检出率为57.31%,其中男性的检出率是74.52%,女性的检出率是23.75%;(2)普通健康人群中男性的hs-cTnT平均水平为(5.59±5.08)ng/L,女性为(3.46±1.45)ng/L,男性与女性hs-cTnT水平有统计学差异(P<0.05),各年龄段hs-cTnT水平比较男性均高于女性;(3)hs-cTnT水平随年龄增长而增大,男性和女性66岁以上人群与其它各年龄组人群的hs-cTnT水平比较均有统计学差异(P<0.05);(4)hs-cTnT与年龄和肾功能指标尿素(urea nitrogen,Urea)、肌酐(creatinine,Crea)尿酸(uric acid,UA)呈明显正相关。结论 hs-cTnT存在性别和年龄的分布差异,应建立不同性别、不同年龄的参考区间;56岁以下女性hs-cTnT检出率较低,将其作为心脑血管疾病早期筛查和监测的指标意义有限。
Objective To understand the distribution characteristics of highly sensitive cardiac troponin-T(hs-cTnT)in the general population in Yuxi area. Methods A total of 1 594 healthy people aged 18-89 years old from July to October 2017 in Yuxi People.s Hospital were selected as samples to study the detection rate and distribution characteristics of hs-cTnT in the general healthy population. The detection rate, distribution characteristics and correlation with routine biochemical indicators of hs-c TnT were analyzed. Results(1) The detection rate of hs-cTnT was 57.31% in the general healthy population,74.52% in males and 23.75% in females.(2) The average level of hs-cTnT was(5.59±5.08)ng/L in males and(3.46±1.45)ng/L in females. There was significant difference between males and females(P < 0.05). The level of hs-cTnT in males was higher than that in females in all age groups.(3) The level of hs-cTnT increased with age. There were significant differences in the levels of hs-cTnT between aged over 66 in both males and females and other groups(P<0.05).(4) hs-c TnT was positively correlated with age and renal function indicators such as urea nitrogen(Urea),creatinine(Crea)and uric acid(UA). Conclusion There is a difference in gender and age distribution between hs-cTnT,and reference intervals of different genders and ages should be established. Since the detection rate of hs-cTnT is lower in women under 56 years old,It has limited significance as an indicator for early screening and monitoring of cardiovascular and cerebrovascular diseases.
Objective To understand the distribution characteristics of highly sensitive cardiac troponin-T(hs-cTnT)in the general population in Yuxi area. Methods A total of 1 594 healthy people aged 18-89 years old from July to October 2017 in Yuxi People.s Hospital were selected as samples to study the detection rate and distribution characteristics of hs-cTnT in the general healthy population. The detection rate, distribution characteristics and correlation with routine biochemical indicators of hs-c TnT were analyzed. Results(1) The detection rate of hs-cTnT was 57.31% in the general healthy population,74.52% in males and 23.75% in females.(2) The average level of hs-cTnT was(5.59±5.08)ng/L in males and(3.46±1.45)ng/L in females. There was significant difference between males and females(P < 0.05). The level of hs-cTnT in males was higher than that in females in all age groups.(3) The level of hs-cTnT increased with age. There were significant differences in the levels of hs-cTnT between aged over 66 in both males and females and other groups(P<0.05).(4) hs-c TnT was positively correlated with age and renal function indicators such as urea nitrogen(Urea),creatinine(Crea)and uric acid(UA). Conclusion There is a difference in gender and age distribution between hs-cTnT,and reference intervals of different genders and ages should be established. Since the detection rate of hs-cTnT is lower in women under 56 years old,It has limited significance as an indicator for early screening and monitoring of cardiovascular and cerebrovascular diseases.
引文
[1]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(1):1-8.
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[4]中华心血管病杂志编辑委员会,中华医学会心血管病学分会.高敏心肌肌钙蛋白在急性冠状动脉综合征中的应用中国专家共识[J].中华心血管病杂志,2012,40(10):809-812.
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[7]Gunsolus IL,Jaffe AS,Sexter A,et al.Sex-specific99th percentiles derived from the AACC Universal Sample Bank for the Roche Gen 5 cTnT assay:Comorbidities and statistical methods influence derivation of reference limits[J].Clinical Biochemistry,2017,50(18):1073-1077.
[8]Koerbin G,Abhayaratna WP,Potter JM,et al.Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays[J].Clinical Biochemistry,2013,46(16-17):1636-1643.
[9]Wu AHB,Christenson RH,Greene DN,et al.Clinical laboratory practice recommendations for the use of cardiac troponin in acute coronary syndrome:expert opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine[J].Clinical Chemistry,2018,64(4):645-655.
[10]宋凌燕,吴炯,宋斌斌,等.高敏感方法检测心肌肌钙蛋白T的分析性能评价[J].中华检验医学杂志,2010,33(9):814-818.
[11]Apple FS,Ler R,Murakami MM.Determination of19 Cardiac Troponin I and T Assay 99th Percentile Values from a Common Presumably Healthy Population[J].Clinical Chemistry,2012,58(11):1574-1581.
[12]郭英,都向阳,黄华兰,等.四川地区高敏肌钙蛋白T参考值的建立及其在胸痛患者中诊断急性心肌梗死的价值[J].四川大学学报(医学版),2017,48(6):905-910.
[13]张干深,罗丽莎,崔芳芳,等.1990年与2015年中国心血管病危险因素疾病负担分析[J].中国卫生统计,2018,35(3):375-379.
[14]胡孝彬,逯心敏,于晓,等.健康人群心肌标志物参考区间调查[J].检验医学,2013,28(7):573-576.
[15]卢丹,吴小慧,桂媛,等.北京地区表观健康成年人群中高敏肌钙蛋白I参考范围的初步建立[J].中华检验医学杂志,2016,39(9):674.
[16]Zhao D,Guallar E,Ouyang P,et al.Endogenous Sex Hormones and Incident Cardiovascular Disease in PostMenopausal Women[J].Journal of the American College of Cardiology,2018,71(22):2555-2566.
[2]马丽媛,吴亚哲,王文,等.《中国心血管病报告2017》要点解读[J].中国心血管杂志,2018,23(1):3-6.
[3]Chenevier-Gobeaux C,Bonnefoy-Cudraz,é,Charpentier S,et al.High-sensitivity cardiac troponin assays:Answers to frequently asked questions[J].Archives of Cardiovascular Diseases,2015,108(2):132-149.
[4]中华心血管病杂志编辑委员会,中华医学会心血管病学分会.高敏心肌肌钙蛋白在急性冠状动脉综合征中的应用中国专家共识[J].中华心血管病杂志,2012,40(10):809-812.
[5]黎卓华,吴学诗,吴丽川,等.高敏肌钙蛋白低水平升高的临床研究[J].检验医学与临床,2014(z1):100-102,103.
[6]Pretorius CJ,Tate JR,Wilgen U,et al.A critical evaluation of the Beckman Coulter,Access hs TnI:Analytical performance,reference interval and concordance[J].Clinical Biochemistry,2018,55:49-55.
[7]Gunsolus IL,Jaffe AS,Sexter A,et al.Sex-specific99th percentiles derived from the AACC Universal Sample Bank for the Roche Gen 5 cTnT assay:Comorbidities and statistical methods influence derivation of reference limits[J].Clinical Biochemistry,2017,50(18):1073-1077.
[8]Koerbin G,Abhayaratna WP,Potter JM,et al.Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays[J].Clinical Biochemistry,2013,46(16-17):1636-1643.
[9]Wu AHB,Christenson RH,Greene DN,et al.Clinical laboratory practice recommendations for the use of cardiac troponin in acute coronary syndrome:expert opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine[J].Clinical Chemistry,2018,64(4):645-655.
[10]宋凌燕,吴炯,宋斌斌,等.高敏感方法检测心肌肌钙蛋白T的分析性能评价[J].中华检验医学杂志,2010,33(9):814-818.
[11]Apple FS,Ler R,Murakami MM.Determination of19 Cardiac Troponin I and T Assay 99th Percentile Values from a Common Presumably Healthy Population[J].Clinical Chemistry,2012,58(11):1574-1581.
[12]郭英,都向阳,黄华兰,等.四川地区高敏肌钙蛋白T参考值的建立及其在胸痛患者中诊断急性心肌梗死的价值[J].四川大学学报(医学版),2017,48(6):905-910.
[13]张干深,罗丽莎,崔芳芳,等.1990年与2015年中国心血管病危险因素疾病负担分析[J].中国卫生统计,2018,35(3):375-379.
[14]胡孝彬,逯心敏,于晓,等.健康人群心肌标志物参考区间调查[J].检验医学,2013,28(7):573-576.
[15]卢丹,吴小慧,桂媛,等.北京地区表观健康成年人群中高敏肌钙蛋白I参考范围的初步建立[J].中华检验医学杂志,2016,39(9):674.
[16]Zhao D,Guallar E,Ouyang P,et al.Endogenous Sex Hormones and Incident Cardiovascular Disease in PostMenopausal Women[J].Journal of the American College of Cardiology,2018,71(22):2555-2566.