高敏肌钙蛋白T与慢性心力衰竭的相关性及对急性心肌梗死的鉴别效果研究

Study of correlation between high-sensitivity cardiac troponin T and chronic cardiac failure and its differentiating effects for acute myocardial infarction

目的研究高敏肌钙蛋白T(hs-cTnT)和慢性心力衰竭(心衰)患者预后的相关性以及对急性心肌梗死(心梗)的鉴别价值。方法选择120例慢性心衰患者作为心衰组,82例急性心梗患者作为心梗组,并选择来院健康体检的80例健康人群作为对照组。在入院第一天即抽血化验各组的hs-cTnT水平,并对心衰组患者进行超声心动图监测,追踪其6个月内的再入院率。结果心梗组血清hs-cTnT水平高于心衰组,差异有统计学意义(P<0.05);心梗组和心衰组血清hs-cTnT水平均高于对照组,差异有统计学意义(P<0.05)。心衰组中心功能Ⅳ级患者hs-cTnT水平高于心功能Ⅲ级患者,心功能Ⅲ级患者的hs-cTnT水平高于心功能Ⅱ级患者,差异均有统计学意义(P<0.05);但心功能Ⅱ级患者的hs-cTnT水平与对照组比较,差异无统计学意义(P>0.05)。hs-cTnT正常组6个月内再入院率为12.12%,低于hs-cTnT升高组患者的29.89%,差异有统计学意义(P<0.05)。结论 hs-cTnT既能够诊断急性心梗,也可以评估慢性心衰患者的病情严重程度并判断预后,并对两者的鉴别诊断提供证据,应在心内科临床中发挥更大的作用。

Objective To study the correlation between high-sensitivity cardiac troponin T(hs-cTnT)and prognosis of chronic cardiac failure patients and its differentiating effects for acute myocardial infarction.Methods There were120chronic cardiac failure patients as heart failure group,82acute myocardial infarctionpatients as myocardial infarction group,and80healthy people for physical examination as control group.hscTnTlevel was tested on first day of admission,and echocardiography monitoring was made on heart failure group.Readmission rate in6months was tracked.Results Myocardial infarction group had higher serum hs-cTnTlevel than heart failure group,and the difference had statistical significance(P<0.05).Myocardial infarction groupand heart failure group had higher serum hs-cTnT lvel than the control group,and their difference had statisticalsignificance(P<0.05).Heart failure group had higher hs-cTnT lvel in cardiac function gradeⅣpatients thangradeⅢpatients,and higher hs-cTnT lvel in cardiac function gradeⅢpatients than cardiac function gradeⅡpatients.Their difference had statistical significance(P<0.05).Cardiac function gradeⅡpatients had no statisticallysignificant difference in average hs-cTnT level comparing with the control group(P>0.05).hs-cTnT normal grouphad lower readmission rate in6months as12.12%than29.89%in hs-cTnT rising group,and the difference hadstatistical significance(P<0.05).Conclusion hs-cTnT can not only diagnose acute myocardial infarction,butalso evaluate disease severity and prognosis in patients with chronic heart failure,and to provide evidence for thedifferential diagnosis.So it should play a bigger role in cardiology.