肌钙蛋白和C-反应蛋白在缺血性心肌病与扩张型心肌病中的变化

目的探讨肌钙蛋白（cTn-I）和超敏G反应蛋白（hs-CRP）在缺血性心肌病与扩张型心肌病患者中的变化。方法101例心肌病患者行冠脉造影检查，分为缺血性心肌病组（ICM组，53例）和扩张型心肌病组（DCM组，48例）。测定患者在不同NYHA分级时血清cTn-I和hs-CRP浓度。结果ICM患者平均血清hs-CRP浓度高于DCM患者，分别为（4．13±1107）和（2．64±1．19）mg／L；在相同NYHA时，ICM患者的血清hs-CRP浓度明显高于DCM患者（P〈0．01）。ICM患者血清平均cTn-I浓度与DCM患者相似，分别为（0．31±0．27）和（0．34±0．33）μg／L；ICM和DCM患者血清cTn-I浓度在相同NYHA时比较无显著性差异（P〉0．05）。无论是ICM患者还是DCM患者，血清hs-CRP和cTn-I浓度均随心衰程度加重而增高，NYHA Ⅲ和Ⅳ级患者血清hs-CRP和cTn-I浓度明显高于NYHA Ⅰ和Ⅱ级患者（P〈0．01）。结论ICM患者和DCM患者血清hs-CRP和cTn-I浓度随心衰程度加重而增高。ICM患者血清hs-CRP浓度明显高于DCM患者，而两组cTn-I浓度比较无显著性差异。心衰患者cTn-I升高非冠状动脉缺血所致，而与心衰本身有关。

Changes of serum cardiac troponin and C-reactive protein in the patients with ischemic cardiomyopathy and dilated cardiomyopathy

Objective To investigate the level of serum cardiac troponin I（cTn-I） and high-sensitivity C-reactive protein（hs-CRP） in the patients with ischemic cardiomyopathy（ICM） and dilated cardiomyopathy（DCM）. Methods According to the results of coronary angiography, 101 cases of cardiomyopathy patients were divided into group DCM showing normal coronary arteries and group ICM showing coronary heart disease, cTn-I and hs-CRP levels were measured at different NYHA cardiac function classes. Results Average hs-CRP level in patients with ICM was higher than that in patients with DCM [（4.13±1.07） and （2.64±1.19）mg/L]. At the same class of cardiac function,hs-CRP levels in patients with ICM were significantly higher than those in patients with DCM（P〈0.01）. Average cTn-I levels in ICM group and DCM group were similar [（0.31±0.27） and （0.34±0.33） μg/L]. At the same class of cardiac function, the levels of serum cTn-I were similar between ICM group and DCM group（P〉0.05）. Both in ICM group and DCM group, higher the class of cardiac function, higher the levels of serum cTn-I and hs-CRP. Patients with NYHA Ⅲ and Ⅳ had higher cTn-I and hs-CRP levels compared with patients with NYHA Ⅰand NYHA Ⅱ in both groups（P 〈0.05）. Conclusion The hs-CRP levels in patients with ICM were significantly higher than those in patients with DCM, while the levels of serum cTn-I were similar between ICM group and DCM group. Permanent cTn-I release is a common finding in patients with chronic heart failure. In this setting, coronary lesion seems to play a minor role in disease progression. High levels of hs-CRP and serum cTn-I are associated with features of severe heart failure.