老年慢性心力衰竭患者血清肌钙蛋白T及尿酸检测的临床意义

目的探讨老年慢性心力衰竭（CHF）患者血清肌钙蛋白T（cTnT）及尿酸（UA）水平检测的意义。方法回顾性分析200例老年慢性心力衰竭患者临床资料，心功能Ⅰ级为对照组，Ⅱ、Ⅲ、Ⅳ级患者为观察组，每组50例。分析血UA、cTnT与慢性心力衰竭的发生是否存在相关性。按cTnT浓度分为正常组和增高组，比较其住院期间及随访2年发生的心脏事件（心力衰竭反复或加重、死亡）的发生情况。结果观察组cTnT与UA含量明显高于对照组。cTnT增高组患者心脏事件的发生率明显高于正常组（P〈0．05）。结论心衰越重，cTnT与UA增高越明显，血尿酸、肌钙蛋白T与充血性心力衰竭密切相关，是充血性心力衰竭发病的危险因素，二者联合可作为评价老年心力衰竭严重程度的指标。cTnT对判断老年慢性心力衰竭患者的预后有较好的预测价值。

Clinical Significance of Serum Cardiac Troponin T and Serum uric acid levels in Aged Patients with Chronic Congestive Heart Failure

Objective To evaluate the correlations of serum cardiac troponin T and serum uric acid levels in in aged patients with chronic congestive heart failure(CHF) and the effect of cardiac troponin T(cTnT) on the prognosis of the CHF. Methods 200 cases of congestive heart failure patients(Cardiac function NYHA class Ⅰ-Ⅳ) were enrolled for retrospective analysis and divided into four groups ,50 cases per group;randomly picked 50 cases of pantients with cardiac function NYHA class Ⅰ as a control group; and analyzed the relationship of serum uric (UA) and cTnT level and the occurrence of CHF. All the patients were arranged into normal group and higher group according to cTnT concentration. Cardiac events, including repeated or aggravated heart failure or cardiac death,in patients with increased cTnT during hospitalization were compared to those without it. Results In congestive heart failure group (Cardiac function NYHA class Ⅱ-Ⅳ) ,the cTnT and UA contents increased significantly than that in control group.Incidence of cardiac events was higher in patients with increased cTnT than without it (P ＜ 0.05). Conclusion The heavier the congestive heart failure, the blood uric acid and troponin T were more elevated, so they were closely linked with congestive heart failure, and were the factor for onset of congestive heart failure, and could be combined to evaluate the severity of heart failure in aged patients. The cTnT could predict the prognosis of the old patients with CHF.