目的基于四川地区大样本健康人群,根据不同年龄及性别,建立高敏肌钙蛋白T(hs-cTnT)第99百分位参考值,并通过回顾性研究验证建立的参考值在胸痛患者中诊断急性心肌梗死(AMI)的价值。方法随机挑选成都市8个独立社区各个年龄段的志愿者,通过问卷调查记录志愿者基本资料并进行体格、心电图、超声检查等确定健康志愿者。采集血液分析hs-cTnT水平,按性别和年龄建立hs-cTnT第99百分位参考值。同时回顾性纳入2009年7月至2014年7月四川大学华西医院急诊收治的胸痛患者2 249例,比较本次研究建立的参考值(14ng/L)与厂商所提供的参考值诊断急诊胸痛患者发生AMI的灵敏度、特异度、阳性预测值和阴性预测值。结果共纳入1 305例符合标准的健康志愿者,其中男性hs-cTnT水平为4.3(3.2~5.9)ng/L,高于女性3.0(3.0~3.1)ng/L,差异有统计学意义(P<0.01)。男性和女性年龄与hs-cTnT的相关系数分别为0.43和0.29(P<0.01),呈正相关。<45岁、45~<60岁和≥60岁年龄段男性hs-cTnT第99百分位值分别为10.8ng/L、15.4ng/L和19.7ng/L,女性分别为4.6ng/L、8.9ng/L、18.8ng/L。回顾性纳入急诊胸痛患者2 249例采用新确立的第99百分位值与14.0ng/L分别进行验证,60岁以下人群,本研究建立的参考值和14.0ng/L比较其诊断价值无差异,60岁及以上人群,其诊断AMI的灵敏度和阴性预测值差异无统计学意义(P>0.05),特异度和阳性预测值明显提高(男性:0.67vs.0.56,0.83vs.0.79,P<0.05;女性:0.75vs.0.68,0.74vs.0.69,P<0.05)。结论 60岁以下中国四川地区人群hs-cTnT第99百分位参考值为14.0ng/L,60岁及以上人群为20.0ng/L。 Objective To establish a 99th percentile reference value of hs-cTnT based on different age and gender in large sample healthy population of Sichuan Province and to diagnose acute patients with chest pain by retrospectively validating the established reference value The value of myocardial infarction (AMI). Methods Volunteers from 8 independent communities in Chengdu were randomly selected. Volunteers were recorded by questionnaires and their physical, electrocardiogram and ultrasonography were used to identify healthy volunteers. Blood was collected for hs-cTnT levels and the 99th percentile hs-cTnT reference was established by sex and age. At the same time, retrospectively included 2 249 cases of chest pain admitted to West China Hospital of Sichuan University from July 2009 to July 2014. The reference value (14ng / L) and the reference value provided by the manufacturer were compared to diagnose the patients with chest pain Sensitivity, specificity, positive predictive value and negative predictive value of AMI occurred. Results A total of 1 305 healthy volunteers were enrolled in this study. The male hs-cTnT level was 4.3 (3.2-5.9) ng / L, higher than that of 3.0 (3.0-3.1) ng / L in women (P <0.01). The correlation coefficients between male and female age and hs-cTnT were 0.43 and 0.29, respectively (P <0.01), which were positively correlated. The 99th percentile value of hs-cTnT in men younger than 45, 45-60, and 60 years old was 10.8 ng / L, 15.4 ng / L and 19.7 ng / L, respectively, and 4.6 ng / L for women, 8.9ng / L, 18.8ng / L. Retrospective analysis of 2 249 emergency chest pain patients with the newly established 99th percentile value and 14.0ng / L, respectively, were verified in 60-year-old population, the reference value established in this study and 14.0ng / L compared with no difference in diagnostic value The sensitivity and negative predictive value of AMI in diagnosis of 60 years old and above were not statistically significant (P> 0.05), and the predictive value of specificity and positive expression were significantly increased (male: 0.67vs.0.56,0.83vs.0.79, P < 0.05; women: 0.75vs.0.68,0.74vs.0.69, P <0.05). Conclusions The 99th percentile of hs-cTnT in Chinese population under 60 years of age in Sichuan province is 14.0ng / L and 20.0ng / L in patients over 60 years of age.