Evaluation On Clinical Application Of High Sensitivity Cardiac Troponin T

Objective:Through the analysis of the results of high sensitivity cardiac troponin T(Hs-cTnT)test in patients of large-scale general hospitals,the optimal diagnostic cut-off point of high sensitivity troponin T for diagnosis of AMI was discussed and obtained.At the same time,different ages and genders were grouped to analyze the difference of the best diagnostic cut-off points of different ages and genders.The differences of high sensitivity cardiac troponin T concentrations between patients with non-acute myocardial infarction of different ages,genders and different underlying diseases were observed,which provided a reference for clinical diagnosis.Methods:The data of the initial detection of high sensitivity troponin T from all patients in four districts of our hospital were collected from November 2018 to July 2019 using the method of clinical epidemiological investigation and taking the final clinical diagnosis as the gold standard,the ROC curve was drawn.Based on the diagnostic cut-off points currently used in our hospital,the sensitivity and specificity of the detection system and the corresponding population in our hospital were obtained,and the optimal diagnostic cut-off point of the detection system and the corresponding population were determined according to ROC curve.All the data were divided into AMI group and non-AMI group,and the non-AMI group was divided into two groups according to gender:male and female.The non-AMI group was divided into ten groups according to age:group children(0-10 years old),group 10s(11-20 years old),group 20s(21-30 years old),group 30s(31-40 years old),group 40s(41-50 years old),group 50s(51-60 years old),group 60s(61-70 years old),group 70s(71-80 years old),group 80s(81-90 years old)and group over 91 years old.The non-AMI group was divided into four groups according to basic diseases:group heart failure,group chronic kidney disease,group diabetes and group tumor.The data of each group were tested for normality and homogeneity of variance.The analysis of variance was carried out according to the normal distribution and homogeneity of variance test.The non-parametric test of multiple independent samples was carried out for inconsistencies.The statistical results were used to judge whether there were statistical significance among the data of each group.All the data collected were grouped according to age and sex,and were divided into 9 groups:group male,group female,under 30 years old,group 30s(31?40 years old),group 40s(41?50 years old),group 50s(51?60 years old),group 60s(61?70 years old),group 70s(71?80 years old)and group over 80 years old.The ROC curve of each group was drawn to find the best diagnostic cut-off point and its corresponding sensitivity and specificity.Results:1 According to the ROC curve,it was concluded that the sensitivity and specificity of using 0.014 ?g/L as the cut-off point in the diagnosis of AMI were 0.9766 and 0.6404,respectively.The optimal diagnostic cut-off point was 0.1005,and the corresponding sensitivity and specificity were 0.8898 and 0.9582,respectively.2 The results of normality test and variance homogeneity test in non-AMI male and female groups were P<0.05,the results of non-parametric test of multiple independent samples were P<0.05,and the difference of high sensitivity cardiac troponin T concentration was statistically significant.In addition,the results of normality test and homogeneity of variance test in different age groups of non-AMI were P<0.05,and the results of non-parametric test of multiple independent samples were P<0.05.There was significant difference in the concentration of high sensitivity cardiac troponin T between different age groups(P<0.05).The normality test and homogeneity of variance test indicated P<0.05 in different disease groups of non-AMI,and the results of non-parametric test of multiple independent samples were P<0.05.There was significant difference in the concentration of high sensitivity cardiac troponin T between different disease groups(P<0.05).3 According to the results of grouping statistics,the optimal diagnostic cut-off point for men was 0.0935,and the sensitivity was 0.8904 and the specificity was 0.9484,and as for women,the optimal diagnostic cut-off point was 0.0795,and the sensitivity and specificity were 0.9235 and 0.9484,respectively.In terms of the age,the optimal diagnostic cut-off point for people under 30 years old was 0.0195,the sensitivity was 1.0000 and the specificity was 0.9120.Besides,the optimal diagnostic cut-off point for people aged 3-40 years old was 0.0455,and the sensitivity and specificity were 1.0000 and 0.9195,respectively.The optimal diagnostic cut-off point for 41?50-year-old population was 0.1095,the sensitivity was 0.8841 and the specificity was 0.9651.Moreover,the optimal diagnostic cut-off point for 51?60-year-old population was 0.0865,and the sensitivity and specificity were 0.9381 and 0.9620,respectively.As for 61?70-year-old population,the optimal diagnostic cut-off point was 0.0585,the sensitivity was 0.8692 and the specificity was 0.9407.For 70?80-year-old,the optimal diagnostic cut-off point was 0.0795,and the sensitivity and specificity were 0.8943 and 0.9421,respectively.The optimal diagnostic cut-off point for people over 81 years old was 0.1015,with a sensitivity of 0.9431 and a specificity of 0.9314.Conclusion:1 In our hospital,the appropriate diagnostic cut-off point can be selected according to the needs of the different sensitivity and specificity of patients.2 The diagnostic cut-off points of different age groups and genders can be set differently.3 There were differences in the results of cTn among different gender,age and underlying diseases.