肌钙蛋白T在急性失代偿性心力衰竭监测中的意义

Role of troponin T in the monitoring of acute decompensated heart failure

目的观察急性失代偿性心力衰竭患者的肌钙蛋白变化，并分析其与患者预后的关系。方法120例急性失代偿性心力衰竭患者，于入院后即测定肌钙蛋白并记录患者的年龄、性别、心电图变化、预后及治疗情况等。将患者分为肌钙蛋白阳性组与肌钙蛋白阴性组，比较两组患者药物使用率、机械通气率及死亡率情况。结果全部患者中有11例患者肌钙蛋白升高，升高率为9．2％。肌钙蛋白阳性患者入院时收缩压低于阴性患者（P=0．009；〈0．05）；机械通气率、死亡率高于阴性患者（P=0．044，0．012；〈0．05）；两组患者的利尿剂、扩血管药物及多巴胺和（或）多巴酚丁胺使用率差异无统计学意义（P=0．947，0．941，0．200；〉0．05）。结论肌钙蛋白可在急性失代偿性心力衰竭患者中升高。肌钙蛋白升高患者机械通气发生率高、预后差。肌钙蛋白升高可能是与治疗无关的独立危险因素。

Objective To observe the change of troponin T and the relationship with the prognosis in the patients with acute decompensated heart failure. Method To record 120 acute deeompensated heart failure patients＇age, sex, ECG change , treatment and prognosis, and to divide them into the troponin T positive group and negative group. Medicine, mechanical ventilation rate and mortality were compared. Result Troponin T increased in 11 （9.2%） of all the patients. Compare with the troponin T negative group, the positive group＇s systolic blood pressure were lower （P = 0. 009; 〈0.05）, mechanical ventilation rate and mortality were higher in the troponin T positive group （P =0. 044, 0. 012; 〈 0.05） , there was no statistical difference diuretic, vasodilator, dopamine and/or dobutamine between two groups （ P = 0. 947, 0. 941, 0. 200 ; 〉 0.05 ）. Conclusion Patients have high level of troponin T in acute decompensated heart failure. Their mechanical ventilation rate is high and prognosis is poor. Troponin T may be the independeut risk factor of acute decompensated heart failure.