2023 年第 9 期 第 18 卷

性别和年龄对高敏心肌肌钙蛋白T诊断急性心肌梗死截断值及效能的影响分析

Effects of gender and age on the cut-off value and diagnostic efficiency of high-sensitivity cardiac troponin T for the diagnosis of acute myocardial infarction

作者：郑煜博1杨伟1闫淼佳2王颖3梁艳丽1张倩1任延平1

英文作者：Zheng Yubo1 Yang Wei1 Yan Miaojia2 Wang Ying3 Liang Yanli1 Zhang Qian1 Ren Yanping1

单位：1西安交通大学第一附属医院老年内一科，西安710061；2西安交通大学第一附属医院医务部，西安710061；3西安交通大学第一附属医院涉外病房，西安710061

英文单位：1First Department of Geriatric Internal Medicine the First Affiliated Hospital of Xi′an Jiaotong University Xi′an 710061 China; 2Department of Medical Administration the First Affiliated Hospital of Xi′an Jiaotong University Xi′an 710061 China; 3Department of International Medical Center the First Affiliated Hospital of Xi′an Jiaotong University Xi′an 710061 China

关键词：急性心肌梗死；高敏心肌肌钙蛋白T；截断值；诊断效能

英文关键词：Acutemyocardialinfarction;High-sensitivitycardiactroponinT;Cut-offvalue;Diagnosticefficiency

• 摘要：

• 目的  探讨性别和年龄对高敏心肌肌钙蛋白T（hs-cTnT）诊断急性心肌梗死（AMI）截断值及效能的影响。方法 收集西安交通大学第一附属医院2013年6月至2021年9月有hs-cTnT检测结果的17 373例住院患者的病历资料进行回顾性分析。对于总体及不同性别和年龄的患者，绘制受试者工作特征曲线，确定hs-cTnT诊断AMI的最佳截断值和敏感度、特异度并分析差异。结果 受试者工作特征曲线分析结果显示，不同性别和年龄hs-cTnT诊断AMI的截断值不同，男性和女性分别为0.029 5、0.018 5 μg/L，20～39岁、40～59岁、60～79岁、≥80岁分别为0.012 5、0.017 5、0.025 5、0.032 5 μg/L，呈现出男性hs-cTnT高于女性，且随着年龄增加而增加的特点；总体、男性、女性和上述年龄段患者中诊断的敏感度分别为87.6%、85.2%、89.3%、97.1%、89.1%、87.3%、82.9%，特异度分别为91.1%、92.3%、92.1%、86.2%、90.7%、93.0%、91.3%。结论 在AMI的诊断中需要考虑性别、年龄对hs-cTnT诊断效能的影响，根据特定人群建立不同的诊断截断值对AMI的临床诊治有利。

• Objective To investigate the effects of gender and age on the cut-off value and diagnostic efficiency of high-sensitivity cardiac troponin T (hs-cTnT) for the diagnosis of acute myocardial infarction(AMI). Methods The medical records of 17 373 inpatients who had hs-cTnT test result from June 2013 to September 2021 in the First Affiliated Hospital of Xi′an Jiaotong University were collected for retrospective analysis. For overall and different genders and ages patients, receiver operating characteristic (ROC) curves were drawn to determine the optimal cut-off value, sensitivity and specificity for hs-cTnT to diagnose AMI, and the differences were analyzed between them. Results The ROC curve analysis showed that the cut-off values of hs-cTnT for the diagnosis of AMI differed by gender and age, with 0.029 5 and 0.018 5 μg/L for men and women, respectively; the cut-off values were 0.012 5, 0.017 5, 0.025 5, and 0.032 5 μg/L for ages 20-39, 40-59, 60-79, and ≥80 years, respectively. It showed a higher level of hs-cTnT in men, and an increase with age; the sensitivity of diagnosis was 87.6%, 85.2%, 89.3%, 97.1%, 89.1%, 87.3% and 82.9% for overall, male, female and above age patients respectively, and the specificity was 91.1%, 92.3%, 92.1%, 86.2%, 90.7%, 93.0% and 91.3%, respectively. Conclusions  The influence of gender and age on the diagnostic efficacy of hs-cTnT needs to be considered in the diagnosis of AMI, and establishing different diagnostic optimal cut-off based on specific populations is beneficial for the clinical diagnosis and treatment of AMI.