慢性充血性心力衰竭病人血清心肌肌钙蛋白T浓度的变化及临床意义

Clinical Significance of Serum Cardiac Troponin T in Chronic Congestive Heart Failure

目的：观察慢性充血性心力衰竭（ＣＨＦ）病人血清心肌肌钙蛋白Ｔ（ｃＴｎＴ）水平是否升高。 方法：应用酶联免疫吸附分析法检测１９０例ＣＨＦ病人（心力衰竭组）和７５名健康人（对照组）血清ｃＴｎＴ。 结果：心力衰竭组 ｃＴｎＴ浓度为 ０．２３± ０．１７ｎｇ／ｍｌ，对照组 ｃＴｎＴ浓度为 ０．０３± ０．０１ｎｇ／ｍｌ，两组比较有非常显 著差异（Ｐ＜０．０１）。１０５例病人左心室射血分数（ＬＶＥＦ）≤０．３５，其血清ｃＴｎＴ浓度为０．３１±０．２２ ｎｇ／ｍｌ；８５例病人 ＬＶＥ＞０．３５，其血清 ｃＦｎＴ浓度为 ０．１３±０．０７ｎｇ／ｍ，二者比较有非常显著性差异（Ｐ＜０．０１）。心功能分别为Ⅱ。 Ⅲ、Ⅳ级（ＮＹＨＡ）的病人，其血清ｃＴｎＴ浓度分别为０．１１±０．１０ｎｇ／ｍｌ、０．１９±０．２０ｎｇ／ｍｌ、０．３８±０．２１ ｎｇ／ｍｌ（Ⅱ级 与Ⅲ级相比见级与Ⅳ级相比均有非常显著差异，Ｐ＜０．０１）。血清中的心肌 ｃＴｎＴ浓度与左心室射血分数成负相关（γ＝ －０．４９３，Ｐ＜０．００１）。 结论：ＣＨＦ病人血清ｃＴｎＴ浓度升高，其升高程度和心力衰竭严重程度相平行。

Objective: To determine whether the level of serum cardiac troponin T (cTnT)was increased in patients with chronic congestive heart failure (CHF). Methods: Serum cTnT was measured by thrombin enzymelinked immunosorbent assay in 190 patients with CHF and 75 healthy people. Results: cTnT concentration was 0.23 ± 0.17 ng/ml in CHF patients and 0.03 ± 0.01 ng/ml in controls (p <0.01) . In 105 patients with left ventricular ejection fraction (LVEF)≤0.35, cTnT was 0.31 ± 0.22 ng/ml. In 85 patients with LVEF>0.35, cTnT was0.13±0.07ng/ml (p<0.01).In patients with NYHA class II, Ⅲ, Ⅳ, cTnT value were 0.11±0.10 ng/ml, 0.19±0.20ng/ml, 0.38±0.21 ng/ml respectively (classⅡ vs. class III and class Ⅲ vs. class Ⅳ p<0.01) A negative correlation was observed between sera cTnT concentration and LVEF in patients with CHF - 0.493, p < 0.001). Conclusions:Serum cTnT were increased in patients with CHF and the level of cTnT paralleled the severity of CHF