慢性肾功能衰竭患者血清心肌肌钙蛋白Ⅰ的研究

目的观察慢性肾功能衰竭（CRF）血清心肌肌钙蛋白（cTnI）的异常变化及其与心血管疾病的相关性。方法131例慢性肾衰竭患者（56例有胸闷、心悸等症状，75例无症状）和70例正常人于空腹状态抽取外周静脉血，用双抗夹心酶联免疫吸附法检测cTnI，并检测血清肌酐、糖化血红蛋白，进行12导联心电图（EKG）、二维超声心动图（UCG）检查，同时记录血压、临床症状。结果慢性肾功能衰竭组的cTnI水平为（0．103±0．451）ng／ml，显著高于健康对照组[（0．016±0．062）ng／ml，P〈0．05]。慢性肾衰患有症状组的cTnI水平为（0．382±1．610）ng／ml，显著高于无症状组[（0．073±0．158）ng／ml，P〈0．05]。有症状组cTnI异常率分别为33．9％，显著高于无症状组（8．0％，P〈0．05）；有症状组、EKG、UCG异常率分别为87．5％和69．64，与无症状组相比均无显著性差异（76．0％和56．0％，均P〉0．05）。cTnI升高与肌酐水平、血压、血糖、透析方式均无相关性。结论CRF患者cTnI水平显著高于健康人群，心肌损伤发生率极高，cTnI可作为心肌损伤的更特异的预测指标并用以判断预后。

Serum cardiac troponin I level in patients with chronic renal failure

Objective To investigate the serum cardiac troponin I （cTnI） level in the patient with chronic renal failure （CRF） and its correlation with the cardiovascular events. Methods Peripheral blood samples were collected from 131 CRF patients, 79 males and 52 females, aged （58.21± 14.11 ）（26-85）, 56 with symptoms such as chest distress, palpitation, etc., and 75 asymptomatic, and 70 healthy persons undergoing physical check-up as controls. Enzyme-linked immunosorbent assay was used to test the level of serum cTnI. Glycohemoglobin （HbAlc） and serum creatinine were examined too. All subjects underwent electrocardiography （ECG） and ultrasound cardiography （UCG）.Results The level of serum cTnI of the CRF patients were （0.103±0.451）ng/ml, significantly higher than that of the control group [（0.016±0.062）ng/ml, P〈0.05}. The level of serum cTnI of the symptomatic patients was （0.382± 1.610）ng/ml, significantly higher than that of the symptomatic patients [0.073± 0.158） ng/ml, P〈0.05]. The abnormal rate of cTnl of the symptomatic group was 33.9%, significantly higher than that of the asymptomatic group （8.0%, P〈0.05）. The ECG and UCG abnormal rates of the symptomatic group were 87.5% and 69.64% respectively, both not significantly different from those of the asymptomatic group （76.0% and 56.0% respectively, both P〉0.05）.The level of cTnI was not correlated to Cr level, blood glucose, blood pressure, and dialysis modality. Conclusion The cTnI level is a good indicator for myocardium damage often seen in the patients with chronic renal failure.