血清心肌肌钙蛋白T对充血性心力衰竭患者预后的判断价值

Value of serum cardiac troponin T levels for evaluating the prognosis in patients with congestive heart failure

目的:观察血清心肌肌钙蛋白T(cTnT)水平与充血性心力衰竭(CHF)患者预后的关系。方法:选择265例CHF患者和75例健康者,应用电化学发光免疫法检测血清cTnT水平。结果:CHF患者血清cTnT为(0.181±0.536)μg/L,健康对照者为(0.003±0.001)μg/L(P<0.01)。105例左室射血分数(LVEF)≤35％者,cTnT水平为(0.31±0.22)μg/L,160例LVEF>35％者,cTnT为(0.07±0.05)μg/L(P<0.01)。LVEF值与cTnT水平呈负相关(r=0.493,P<0.01)。心功能(NYHA)为Ⅰ、Ⅱ、Ⅲ、Ⅳ级者,其血清cTnT分别为(0.06±0.02)、(0.11±0.10)、(0.19±0.20)、(0.38±0.21)μg/L。随访6个月,观察终点为心力衰竭死亡。血清cTnT≥0.1μg/L55例,失访2例,死亡17例,病死率为32.00％;cTnT<0.1～≥0.05 μg/L 86例,失访3例,死亡8例,病死率为9.64％;cTnT<0.05μg/L 124例,失访2例,死亡3例,病死率为2.46％。结论:CHF患者血清cTnT水平升高,其升高程度与心力衰竭严重程度相平行,并预示患者预后不良。

Objective:To determine whether the level of serum cardiac troponin T (cTnT) had prognostic value in patients with congestive heart failure (CHF). Methods: Serum cTnT was measured by electrochemiluminescence immunoassay. Results:cTnT concentration was (0. 181±0. 536) μg/L in CHF patients and (0. 003 ± 0. 001) μg/L in controls ( P<0.01). In patients with LVEF≤0. 35 and >0. 35, cTnT was (0. 31±0. 22 ) and (0. 07±0. 05) μg/L ( P<0. 01). In patients with heart function class Ⅰ , Ⅱ,Ⅲ , and Ⅳ , cTnT was (0.06 ± 0.02) μg/L, (0. 11 ± 0. 10) μg/L, (0. 19 ± 0. 20) μg/L and (0. 38 ± 0. 21) μg/L, respectively. A negative correlation was observed between serum cTnT concentration and LVEF in patients with CHF ( r = -0. 493, P <0. 01). According to the concentration of cTnT, 55 patients with cTnT≥0.1 μg/L had fatality rate of 32. 00% , 86 patients with cT-nT<0. 1μg/L and ≥0. 05 μg/L had fatality rate of 9. 64% , and and 124 patients with cTnT<0. 05μg/L had fatality rate of 2. 46%. Conclusion: This study shows that serum cTnT is increased and has prognostic value in patients with CHF, that the level of cTnT is parallel to the severity of CHF.