血液透析患者血清肌钙蛋白Ⅰ检测对心血管病的预测价值

目的：维持性血液透析患者经常观察到肌钙蛋白T（cTnT）升高,且同心血管病发病率和死亡率密切相关。明确cTnI的升高是否有同样的临床意义。方法：我们研究了97例维持性血液透析患者,这些患者没有明显的急性冠状动脉疾病临床表现。血透前检测患者的cTnI,每3个月检测1次,一共检测5次。随访时间1年,监测患者的临床表现,X线片,心脏超声心动图。设定cTnI≥0.15ng/ml为阳性,而〈0.15ng/ml为阴性。结果：97例患者中有13例患者cTnI升高,9例（69%）在1年的随访期间出现了急性心血管事件。而在69例cTnI正常的患者中仅有7例（10.1%）患者出现急性心血管事件。在另外15例患者中,cTnI在正常值上下波动,有3例（20%）出现急性心血管事件。结论：基于以上的研究结果,无症状的维持性血液透析患者cTnI是一个有很强心血管病预测价值的血清标记物。cTnI持续升高提示患者早期进行全面的心血管病检测和治疗,预防急性心血管事件,并从中获益。

Prognostic Value of Serum Cardiac Troponin Ⅰ in Chronic Dialysis Patients

Objective：We sought to evaluate the prognostic value of cardiac troponin Ⅰ （cTnI） in asymptomatic patients with chronic renal failure treated with long-term hemodialysis.Methods：In the present study, 97 patients at a single centre were followed prospectively after five determinations of cTnI at 3-month intervals. The outcome after 12 months was chosen as the end-point.We considered patients with serum cTnIor=0.15 ng/ml as positive and those with levels 0.15 ng/ml as negative.Results：Among the 13 patients with high serum cTnI levels, nine （69%） suffered acute cardiac events during the 12-month follow-up. In contrast, among the 69 patients with low cTnI levels only seven （10.1%） had acute events. In another group of 15 patients with variable cTnI levels, three patients （20%） had cardiac events.Conclusion：cTnI is elevated in a large number of patients on regular haemodialysis and is a significant independent predictor of outcome. For those patients who might benefit from thorough cardiac investigation and treatment, information on cTnI could be useful in preventing cardiac events.