心肌肌钙蛋白Ⅰ与心力衰竭远期心脏事件的关系探讨

Relationship of Cardiac Troponin I to the Late Heart Events in Patients with Heart Failure

目的:探讨心力衰竭患者血清心肌肌钙蛋白I(cTnI)水平与心脏功能及远期心脏事件的关系。方法:测定66例心力衰竭患者血清cTnI,肌酸激酶同功酶(CK-MB),并分为cTnI正常组和升高组,随访至少12月患者远期心脏事件,分析cTnI与心脏功能及远期心脏事件的关系。结果:66例心力衰竭患者中有27例血清cTnI升高,5例CK-MB轻度升高;Ⅲ级心功患者cTnI升高检出率(66.7％)比Ⅱ级心功cTnI升高检出率(5.9％),显著增高(P<0.05);Ⅳ级心功患者cT-nI升高检出率(100％)比Ⅲ级心功患者明显增高(P<0.05)。62例心力衰竭患者远期随访,随访时间(18±6)个月,cTnI正常组远期心脏事件17例次,cTnI升高组远期心脏事件35例次(P<0.01)。结论:心功能越差cTnI升高的检出率越大,血清cTnI不仅是心力衰竭患者心肌损伤的敏感标志物,而且是远期心脏事件的独立预测因子。

Objective: To explore the correlation of serum cardiac troponin Ⅰ (cTnI) and the late heart events in patients with heart failure (HF). Methods: Serum cTnI and creatine kinase isoenzyme MB in 66 patients with HF were measured. These patients were divided into 2 groups based on levels of cTnI, one group with cTnI levels elevated and other group with normal cTnI levels , and late heart events were followed - up. The correlation of cTnI levels and the heart events were analyzed. Results: In 27 of 66 patients cTn levels elevated , while in only 5 of 66 cases creatine kinase isoenzyme MB levels slightly elevated; cTnI was elevated in 2 of 34 New York Heart Association (NYHA )class Ⅱ Patients(5.9%), cTnI was elevated in 14 of 21 NYHA class Ⅲ Patients(66.7%), cTnI was elevated in 11 of 11 NYHA class Ⅳ Patients (100%) .Its rates of detectable cTnI elevated were significant different P<0.05-0.01); the late follow - up t (18 ± 6) months] was finished in 62 patients.The seventeen heart events in patients of normal cTnI were recorded, thirty five heart events in patients of detectable cTnI elevated were recorded (P < 0.01), which positively correlated with cTnI elevation (P < 0.01). Conclusion: Patients with detectable cTnI elevated had significantly worse functional class. Serum cTnI is a highly sensitive marker of minor myocardial damage, and could be an independent indicator of late heart events in patients with HF.