扩张型心肌病血清心肌钙蛋白I水平测定的临床意义

The Clinical Significance of Serum Cardiac Troponin I in Patients with Dilated Cardiomyopathy.

目的 探讨扩张型心肌病 (DCM)心力衰竭急性加重时心肌钙蛋白I(cTnI)水平的临床意义。方法 用化学发光免疫分析法测定 42例DCM患者的血清cTnI水平及用超声心动图测量左心室射血分数 (LVEF) ,并与对照组比较。结果 DCM患者血清cTnI水平显著高于对照组 ( 0 .3 11± 0 .3 78vs 0 .0 13± 0 .0 0 9ng/ml,P <0 .0 0 1) ,DCM组中 17例血清cTnI水平升高 ,且cTnI水平与LVEF呈负相关 (P <0 .0 1) ;DCM组中血清cTnI水平高者 6个月死亡率 2 9.4% ,而血清cTnI水平正常者为 4.0 % (P <0 .0 5 )。结论 DCM患者心力衰竭急性加重cTnI水平升高 ,其水平与心力衰竭严重程度呈正相关 。

Objective To observe the serum cardiac troponin I (cTn I) level in patients with dilated cardiomyopathy (DCM) with advanced chronic heart failure. Methods Serum cTn I was measured in 42 patients with DCM (DCM group) and 40 cases with no heart disease (control group) by chemical immunofluoresence and left ventricular ejection fraction (LVEF) was detected in both groups by echocardiography. Results The serum level of cTn 1 in DCM group was significantly higher than that in control group (0.311±0.378 vs 0.013±0.0009 ng/ml, P <0.01).Moreover,the level of cTn I had a significant negative correlation with LVEF in DCM group(r=-0.582, P <0.01).Among patients with DCM,the 6 months'mortality was 29.4% in patients with elevated serum cTn I,only 4.0% in patients with normal serum cTn I ( P <0.05). Conclusions The higher serum cTn I level was correlated with the severity of DCM and indicated the worse prognosis in patients with DCM.