慢性心力衰竭对超敏肌钙蛋白T影响的临床研究

目的探讨慢性心力衰竭（CHF）患者血清超敏肌钙蛋白T（hs-cTnT）的水平变化与影响。方法选取92例CHF患者为心力衰竭组,依据NYHA心功能分级分为4个亚组：Ⅰ级组26例,Ⅱ级组23例,Ⅲ级组22例,Ⅳ级组21例;选取同期体检中心的20例健康正常者为对照组。检测所有患者的血清hs-cTnT及血浆N末端脑钠肽（NT-proBNP）浓度,并行超声心动图检查,测量左心房舒张期内径（LADd）、左室舒张末期内径（LVEDd）、左室射血分数（LVEF）。结果心力衰竭组的hs-cTnT、NT-proBNP浓度明显高于对照组（P〈0.05）,心力衰竭各亚组间hs-cTnT、NT-proBNP比较,差异有统计学意义（P〈0.05）,且随NYHA分级增加而升高,心力衰竭组中的心功能代偿亚组（Ⅰ级组）hs-cTnT、NT-proBNP浓度高于对照组（P〈0.05）。心力衰竭组的LADd、LVEDd、LVEF与对照组比较,差异有统计学意义（P〈0.05）;心力衰竭各亚组之间的LADd、LVEDd、LVEF比较,差异有统计学意义（P〈0.05）;心力衰竭组中的心功能代偿亚组（Ⅰ级组）的LADd、LVEDd、LVEF与对照组比较,差异无统计学意义（P〈0.05）。结论 CHF患者无论有无心力衰竭症状其血清hs-cTnT水平增高,并与心力衰竭程度及NT-proBNP呈正相关,hs-cTnT能较好地反映CHF患者的心功能状态,检测CHF患者血清hs-cTnT水平对临床诊断治疗和预后判断CHF进展尤为重要。

Clinical study on the influence of chronic heart failure on high-sensitivity cardiac troponin T

Objective To investigate the change of high-sensitivity cardiac troponin T（hs-cTnT） in patients with chronic heart failure（CHF）. Methods 92 cases of patients with CHF were selected as heart failure group,who were divided into 4 subgroups according to the NYHA classification of cardiac function： Ⅰ group（26 cases）,Ⅱ group（23 cases）, Ⅲ group（22 cases）, Ⅳ group（21 cases）;at the same time,20 healthy individuals were selected as control group.Serum hs-cTnT and plasma N-terminal pro-B-type natriuretic peptide（NT-proBNP） of all patients were measured,and were carried out ultrasound heartbeat graph examination to measure left atrium diastole diameter（LADd）,left ventricular end-diastole diameter（LVEDd）,left ventricular ejection fraction（LVEF）. Results The hs-cTnT and NT-proBNP in heart failure group was higher than that of control group（P〈0.05）,hs-cTnT and NT-proBNP between subgroups had significant difference（P〈0.05）,hs-cTnT and NT-proBNP in Ⅰ group was higher than that of the control group（P〈0.05）.LADd,LVEDd,LVEF in heart failure group had significant difference compared with control group（P〈0.05）;LADd,LVEDd,LVEF between subgroups had significant difference（P〈0.05）;LADd,LVEDd,LVEF in Ⅰ group had no significant difference compared with control group（P〉0.05）. Conclusion Patients with CHF has or not has heart failure symptoms,the serum level of hs-cTnT increased,and is positively correlated with the degree of heart failure and NT-proBNP,hs-cTnT can betterly reflect the heart function of patients with CHF.Detecting of serum hs-cTnT level in patients with CHF is important to clinical diagnosis,treatment and prognosis of CHF.