高敏心肌肌钙蛋白T水平与维持性血液透析患者心脏结构和功能的关系

目的 研究高敏心肌肌钙蛋白（hs-cTnT）与维持性血液透析（maintenance hemodialysis,MHD）患者心脏结构和功能的关系.方法 选择86例规律血液透析的慢性肾衰竭患者（每周3次,时间＞6月）,病情稳定,已排除近6个月内曾发生急性心肌梗死、急性心肌炎事件及肥厚性心肌病者,测定血清hs-cTnT、B型脑钠肽（BNP）、生化指标,同时应用心脏超声心动图测量左室射血分数（LVEF）、左室舒张末内径（LVDd）、室间隔厚度（IVST）、左心室后壁厚度（LVPWT）,计算左室心肌重量指数（LVMI）,分析hs-cTnT与心脏结构和功能指标间的关系.同时检测同期来院体检的60名健康体检者的hs-cTnT作对比分析.结果 维持性血液透析组hs-cTnT水平与健康对照组比较明显升高[（0.263±0.038） ng/ml比（0.016±0.008） ng/ml],差异有统计学意义（P＜0.05）,患者中hs-cTnT与BNP、LVMI及LVH呈正相关（P＜0.05）,与LVEF呈负相关（P =0.015）.结论 hs-cTnT的检测对维持性血液透析患者的早期心脏左室肥厚及收缩功能减退有预测作用.

The relationship between highly sensitive cardiac troponin T and cardiac structure and function in patients on maintenance hemodialysis

Objective To investigate the relationship between highly sensitive cardiac troponin T and cardiac structure and function in patients on maintenance hemodialysis （MHD）.Methods Highly sensitive cardiac troponin T （hs-cTnT） and B-type natriuretic peptide （BNP） were measured in 86 patients （MHD group）,who were treated with MHD for at least 6 months before the study and were in a stable clinic status without signs of acute myocardial infarction,acute myocarditis and hypertrophic cardiomyopathy.Left ventricular ejection fraction （LVEF）,left ventricular diameter （LVD）,interventricular septal thickness （IVST）,left ventricular posterior wall thickness （LVPWT） were evaluated by ultrasonic cardiography.The results were compared to those from 60 healthy people （control group）.The relationship between hs-cTnT level and left heart structure and function was then analyzed.Results The mean hs-cTnT level was higher in MHD group than in control group （0.263±0.038 ng/ml vs.0.016±0.008 ng/ml; P＜0.05）.In MHD group,hs-cTnT level was positively correlated with the levels of BNP,LVMI and LVH （P＜0.05）,and was negatively correlated with the level of LVEF （P=0.015）.Conclusions The determination of hs-cTnT is helpful for the early diagnosis of cardiovascular events in patients undergoing maintenance hemodialysis.