Nghiên cứu nồng độ HS-TROPONIN t và HS-CRP trong đánh giá tổn thương động mạch vành ở bệnh nhân hội chứng vành cấp

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Anh Bình Hồ, Quốc Bảo Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học lâm sàng Bệnh viện Trung ương Huế, 2023

Mô tả vật lý: tr.43-50

Bộ sưu tập: Báo, Tạp chí

ID: 343038

Thêm vào giỏ Liên kết toàn văn

Đặt vấn đề: Nồng độ hs-Troponin T được khuyến cáo sử dụng thường xuyên trên lâm sàng có giá trị tiên lượng rất cao mức độ tổn thương động mạch vành ở bệnh nhân hội chứng vành cấp. Trong khi đó, nồng độ CRP độ nhạy cao (hs-CRP) được biết đến là một protein xuất hiện ở pha cấp trong các phản ứng viêm và được các nghiên cứu chỉ ra có liên quan đến xơ vữa động mạch, trong đó có động mạch vành. Do đó chúng tôi tiến hành nghiên cứu này với mục tiêu tìm hiểu mối tương quan giữa nồng độ hs-Troponin T và hs-CRP huyết thanh với mức độ tổn thương động mạch vành ở bệnh nhân hội chứng vành cấp. Đối tượng, phương pháp: Nghiên cứu mô tả cắt ngang gồm 86 bệnh nhân chẩn đoán hội chứng vành cấp có chỉ định chụp và can thiệp động mạch vành tại Khoa Cấp cứu Tim mạch can thiệp - Trung tâm Tim mạch - Bệnh viện Trung Ương Huế từ tháng 6/2020 đến tháng 5/2022. Kết quả: Điểm SYNTAX trung bình trong nghiên cứu là 16,5 ± 7,5. Nồng độ hs-Troponin T và hs-CRP trong nghiên cứu của chúng tôi lần lượt là 0,86 ± 1,55 ng/mL và 9,33 ± 11,5 mg/L. Có sự tương quan thuận mức độ trung bình giữa nồng độ hs-Troponin T và hs-CRP với mức độ tổn thương động mạch vành theo điểm SYNTAX với p = <
0,01 và r lần lượt là +0,387 và +0,471. Diện tích dưới đường cong (ROC) AUC của giá trị nồng độ hs-Troponin T là 0,701 với điểm cut - off là 0,109 ng/ mL dự đoán mức độ tổn thương ĐMV trung bình và cao theo thang điểm SYNTAX, với độ nhạy 76% và độ đặc hiệu 59% trong khi diện tích dưới đường cong (ROC) AUC của giá trị nồng độ hs-CRP là 0,770 với điểm cut - off là 8,52 mg/L dự đoán mức độ tổn thương ĐMV trung bình và cao theo thang điểm SYNTAX, với độ nhạy 68% và độ đặc hiệu 80,3%. Kết luận: Nồng độ hs-troponin T và hs-CRP có mối tương quan thuận chiều mức độ trung bình với mức độ tổn thương động mạch vành theo thang điểm SYNTAX ở bệnh nhân hội chứng vành cấp. Trong khi nồng độ hs-troponin T có độ nhạy cao hơn nhưng độ đặc hiệu thấp hơn trong dự đoán mức độ tổn thương động mạch vành trung bình và cao theo thang điểm SYNTAX ở bệnh nhân hội chứng vành cấp. Từ khóa: Hội chứng vành cấp, thang điểm SYNTAX, troponin T siêu nhạy, CRP siêu nhạy. ABSTRACT HS-TROPONIN T and HS-CRP concentration in the assessment of coronary artery damage in patients with acute coronary syndrome Ho Anh Binh1, Tran Quoc Bao1 Background: The serum of hs-Troponin T, which is recommended for routine clinical use, has a very high prognostic value for the degree of coronary artery damage in patients with acute coronary syndrome. Meanwhile, high - sensitive CRP level (hs-CRP) is a well - known protein in the acute phase of inflammation and have been shown to be associated with arteriosclerosis, including coronary arteries. Therefore, we conducted this study with the goal of understanding the correlation between hs-Troponin T and hs-CRP serum levels with coronary artery damage in patients with acute coronary syndrome. Methods: A cross - sectional descriptive study of 86 patients diagnosed with acute coronary syndrome with indications for coronary angiography and intervention at the Department of Emergency and Interventional Cardiology - Cardiovascular Center - Hue Central Hospital from June 2020 to May 2022. Results: The mean SYNTAX score in the study was 16.5 ± 7.5. There was an association between hs-Troponin T, and hs-CRP with the degree of coronary artery damage according to the SYNTAX score with p <
0.01. There was a positive correlation between the mean levels of hs-Troponin T, and hs-CRP with the degree of coronary artery damage according to the SYNTAX score with p <
0.01 and r were +0.387, and +0.471, respectively. The area under the curve (ROC) AUC of hs-Troponin T concentration value of 0.701 with a cut-off point of 0.109 ng/mL predicted intermediate and high SYNTAX score, with a sensitivity of 76 % and specificity 59% while the area under the curve (ROC) AUC of hs-CRP concentration value was 0.770 with a cut - off point of 8.52 mg/L predicted intermediate and high SYNTAX score, with a sensitivity of 68% and a specificity of 80.3%. Conclusions: The levels of hs-troponin T and hs-CRP had a moderate positive correlation with the degree of coronary artery damage according to the SYNTAX score in patients with acute coronary syndrome. While hs-troponin T levels had higher sensitivity but lower specificity in predicting moderate and high SYNTAX score in patients with acute coronary syndromes as compared to hs-CRP levels.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR