肌钙蛋白（cTnT）在扩张型心肌病患者预后评估中的价值

The Value of Troponin(cTnT) in Prognostic Assessmentof Patients with Dilated Cardiomyopathy

目的:探讨肌钙蛋白(cTnT)在预测扩张型心肌病患者长期预后的临床价值.方法:选取2015年9月—2016年8月河西学院附属张掖人民医院心内科收治的65例扩张型心肌病(DCM)患者为研究对象,根据纽约心功能分级(NYHA)分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级,分别为18、26、9、12例,收集所有患者的临床资料,超声心动图测定左室舒张末期容积(LVEDV)和左心室射血分数(LVEF),检测患者的cTnT和NT-proBNP水平,分析cTnT水平在不同心功能等级之间的相关性及对患者预后的影响.结果:DCM患者随着心功能恶化,cTnT、NT-proBNP逐渐升高,IV级组>III级组>II级组>I级组,不同心功能患者组间差异均有统计学意义(P<0.05).血清cTnT和NT-proBNP成正相关(r=0.884,P<0.001),与LVEF存在负相关(r=-0.929,P<0.001).随着cTnT的升高,心功能逐渐恶化,而NT-proBNP的变化与cTnT同步.结论:DCM患者血清cTnT水平显著升高,并与NT-proBNP和心衰严重程度密切相关,可用于指导心衰治疗和评估预后.

Objective:todiscuss the clinical value of cardiac troponin T(cTnT)in prognosis assessment of patients with dilated cardiomyopathy(DCM).Method:selecting 65 patients with chronic heart failure diagnosed with DCM as the research object from September 2015 to August 2016,who were hospitalized and treated.They were divided into gradesⅠ,Ⅱ,ⅢandⅣ(18,26,9,12 cases respectively),according to New York Heart Association(NYHA)classification.The clinical data of the four groups were collected.Left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)were measured by echocardiography.The serum cTnT and N-terminal-pro-brain natriuretic peptide(NT-proBNP)were measured and correlation analysis was performed.Result:With the worsening of heart function in DCM patients with heart failure,the levels of serum cTnT and NTproBNP were gradually increased(P<0.05).Serum cTnT was positively correlated with NT-proBNP(r=0.884,P<0.001)and negatively correlated with LVEF(r=-0.929,P<0.001).Conclusion:Serum cTnT level significantly increases and is closely related to the NT-proBNP and severity of heart failure with DCM,so it can be used to guide treating and evaluating prognosis of heart failure.