血清肌钙蛋白Ⅰ对充血性心力衰竭预后的影响

Serum cardiac troponin Ⅰ on prognosis of congestive heart failure

目的观察慢性充血性心力衰竭患者不同血清肌钙蛋白I（cTnI）浓度与1年病死率的关系。方法入选2008年1～12月在我院心内科住院的诊断为慢性充血性心力衰竭患者225例，根据住院测定的cTnI浓度将患者分为正常组与异常组，异常组再分为轻度增高组、中度增高组、增高组，记录其住院期间及随访1年发生的心脏性事件。结果225例患者随访1年发生心脏性事件58例（25．8％），异常组病死率依次高于正常组（60．0％〉40．8％〉24．0％〉18．4％，Pd0．01）。logistic回归分析显示，cTnI为慢性充血性心力衰竭预后不良的相关因素。结论cTnI增高是随访1年发生心脏性事件的危险因素（P〈0．05），是死亡的预测因子。血清cTnI〉0．10μg／L的慢性充血性心力衰竭患者为高危人群。

Objective To observe different cardiac troponin I（cTnI） concentrations and the one-year mortality in patients with chronic congestive heart failure. Methods 225 cases hospitalized in January to December 2008 in the hospital with diagnosis as chronic congestive heart failure were enrolled, according to cTnI concentration which was measured during the hospitalization, the patients were arranged into sub-normal and abnormal group, also abnormal group was further divided into mild group, moderately increased group, higher group, respectively, and auxiliary inspection records of history during hospitalization and follow-up within one year of cardiac events were colleeted. Results Out of 225 cases of patients,cardiac events within one year were 58 cases（25.8%）. Abnormal group was higher than the normal group（60.0%〉40.8%〉24.0%〉18.4%, P 〈0.01）. On the impact of cardiac events within one year for chronic congestive heart failure by the logistic regression analysis,cTnI was associated with poor prognosis factors. Conelusion cTnI increase occurred within a year of the risk factors for cardiac events（ P 〈0.05）, it is a predictor of death. Serum troponin I greater than or equal 0.10 μg/L in patients with chronic congestive heart failure is for high-risk groups.