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用肌钙蛋白水平预测心脏病机率

A simple blood test may predict future heart disease.

A number of risk factors can predict your chance of getting a heart attack. High blood pressure or cholesterol, a history of smoking, just getting older - all of these make heart disease more likely.

 

根据一些风险因素,能够预测出你患心肌梗塞的机率。高血压或者高胆固醇,有吸烟史,以及年龄增长等等,都会增加患心脏疾病的可能性。

When a suspected heart attack patient shows up at the hospital, doctors often test for a blood protein called cardiac troponin T, which can confirm a heart attack.

 

当一名疑似心肌梗塞的患者被送到医院时,医生们通常为他做一次血液蛋白、也就是“肌钙蛋白”的检测,以确定是不是心肌梗塞。

The newest versions of the test are super sensitive, measuring the protein at levels of just a few picograms - trillionths of a gram - per milliliter of blood.

 

这项最新的检测方法超级敏感,能在一毫升血液中,筛检出几皮克,也就是万亿分之几克的蛋白。

"And this is allowing us to identify evidence of heart injury - troponin protein is released when heart cells die - in individuals who are seemingly without any obvious cardiovascular disease, whether it be chest pain and heart attacks, or whether it even be symptoms of heart failure," says University of Maryland medical professor Christopher deFilippi.

 

马里兰大学医学教授克里斯多夫·迪菲利比说:“这种方法使我们能够分辩出心脏受损的证据。心脏细胞死亡时会释放出肌钙蛋白,但患者也许没有任何明显的心血管疾病,不管是胸痛,还是心肌梗塞,甚至是心力衰竭。”

DeFilippi and his colleagues tested troponin levels in blood samples taken years ago from a group of almost 6,000 older Americans. Then, the researchers compared troponin levels with the health of the individuals as they aged. They found that higher levels of troponin correlated to a higher likelihood of heart failure, which is when the heart's pumping ability declines.

 

迪菲利比教授和他的同事们检测6,000多名美国中老年人几年前采集的血液样本中的肌钙水平,然后,把肌钙蛋白水平和他们现在的健康状况进行比对。结果发现,较高的肌钙蛋白水平与心力衰竭、也就是心脏输送血液能力下降有关。

"So it could both identify individuals who were at the highest risk for developing the signs and symptoms of a failing heart, and also individuals who were at the highest risk of dying of heart disease."

 

迪菲利比教授说:“因此,它既能找出心力衰竭风险最高的人,又能分辩出死于心脏病的风险最高的人群。”

DeFilippi says the troponin test turns out to be a strong predictor by itself of heart failure or of death from any kind of heart disease, and it does so independent of other risk factors.

 

迪菲利比教授指出,肌钙蛋白检测本身就能很有效地预测心力衰竭和任何心脏病导致的死亡,无须考虑其他风险因素。

"It is, as a blood test, similar to cholesterol, a measure of a continuum of values, so it's not a yes/no answer, but you're able to stratify people into very low risk, low risk, intermediate, [and] high risk for these events based upon the [troponin] number."

 

“就像一般验血查胆固醇一样,衡量一个连续的数值,因此,它的答案不是对或错,而是根据肌钙蛋白水平把人分为极低、低、中、和高风险等级。”

Christopher deFilippi says the test should be relatively affordable since the chemicals used to process each sample, only cost a dollar or so. And patients who learn they are on the path to heart failure can work with their doctor to minimize progression of the disease.

 

迪菲利比教授说,这项检测应该属于价格相对低廉的方法。每次使用的各种试剂,成本不过一美元左右。病患知道自己属于心脏衰竭高风险人群,可以和医生合作,尽可能减缓病情的发展。

DeFilippi's paper describing his research is published online by the journal of the American Medical Association, JAMA.