肌钙蛋白Ⅰ对恶性肿瘤与非恶性肿瘤合并急性肺栓塞患者右心功能障碍的预测价值

摘要

目的 探讨肌钙蛋白Ⅰ(cTnⅠ)对恶性肿瘤与非恶性肿瘤合并急性肺栓塞患者右心功能障碍的预测价值.方法 回顾性196例急性肺栓塞患者的临床资料,将其分为肿瘤组(45例)与非肿瘤组(151例),分析两组患者cTnⅠ预测右心功能障碍的受试者工作特征(ROC)曲线及曲线下面积(AUC),并截取cutoff值.结果 肿瘤组中,cTnⅠ预测右心功能障碍的AUC为0.82(95％ CI 0.70 ～0.96),选取cTnⅠ＞0.047 ng/ml为cutoff值时,敏感性为79％,特异性为86％,阴性似然比为0.244;非肿瘤组中,cTnⅠ预测右心功能障碍的AUC为0.85(95％ CI 0.79～0.91),选取cTnⅠ＞0.024 ng/ml为cutoff值时,敏感性为86％,特异性为72％,阴性似然比为0.194.结论 急性肺栓塞患者的cTnⅠ可以有效预测右心功能障碍,但在非肿瘤组患者中cTnⅠ预测右心功能障碍的有效性高于肿瘤组.%Objective To investigate the predictive value of cardial troponin Ⅰ for right ventricular dysfunction (RVD) in cancer and non-cancer patients with acute pulmonary embolism.Methods The clinical data of 196 patients with acute pulmonary embolism admitted in recent years were retrospectively analyzed.The patients were divided into cancer group(45 cases) and non-cancer groups (151 cases).Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) for cTnⅠ predicting RVD were analyzed and related cutoff levels for both groups were intercepted.Results In the cancer group,analysis of the ROC curves showed an AUC of 0.82 (95％ CI 0.70-0.96) for cTnⅠ predicting RVD with an optimal cutoff value of 0.047 ng/ml,the sensitivity and specificity of the test was 79％ and 86％,the negative likelihood ratio was 0.244.In the non-cancer group,AUC was 0.85(95％ CI 0.79-0.91) for cTnⅠ predicting RVD with an optimal cutoff value of 0.024 ng/ml,the sensitivity and specificity of the test was 86％ and 72％,the negative likelihood ratio was 0.194.Conclusions cTnⅠ is effective for predicting RVD in acute pulmonary embolism patients.However,the effectiveness of cTnⅠ to predict RVD is higher in acute pulmonary embolism patients with non-cancer than that in patients with cancer.