肌钙蛋白T在扩张型心肌病心力衰竭失代偿期患者出院3个月的预后价值

3 moths clinical value of cTnT in HF in decompensated patients with dilated cardiomyopathy

目的:探讨扩张型心肌病(DCM)患者心力衰竭(HF)失代偿期肌钙蛋白T(cTnT)浓度与HF严重程度及出院3个月预后的关系。方法:HF失代偿期住院的DCM患者219例,入院后测定血浆cTnT浓度,进行常规实验室检查及超声心动图检查。将患者分成c Tn T≤0.05ng/ml组(正常组119例)和c Tn T>0.05ng/ml组(升高组100例),分析两组患者入院时的一般资料、检查及出院后3个月内的终点事件(因心力衰竭再住院及心源性死亡)。结果:入院时升高组患者脑利钠肽前体(NT-pro BNP)比正常组患者更高(P <0.05)、射血分数更低(P <0.05)、左室舒张末期内径更大(P <0.05)、NYHA分级达Ⅲ、Ⅳ级的比例更高(P <0.05);升高组患者3个月的终点事件发生率明显高于正常组患者(P <0.05);对患者3个月内终点事件的发生做多因素逻辑回归发现cTnT有统计学意义(P <0.05)。结论:DCM患者HF失代偿期cTnT浓度升高提示患者HF程度更严重、患者3个月内终点事件的发生率更高,对3个月内终点事件发生有独立的预测价值。

Objective:To investigate the relationship between the concentration of T(cTnT)and the severity of HF and the prognosis in patients with dilated cardiomyopathy(DCM).Methods:219 cases of DCM who were hospitalized in HF were divided into two group,the patients were divided into the cTnT≤0.05 ng/ml group(normal group)and c TnT>0.05 ng/ml group(higher group).Analysis of the two groups of patients at the time of admission to the general information,check and the end of the 3 months after discharge(hospitalization for heart failure again and cardiac death).Results:Brain natriuretic peptide(NT proBNP)in group higher group was Higher than that of normal group group of patients admitted to hospital patients(P<0.05),shoot ejection fraction lower(P<0.05),left ventricular end diastolic diameter greater(P<0.05),NYHA class ofⅢ,Ⅳratio higher(P<0.05);patients in group higher group and 3 months of end point occurrence rate was significantly higher than that of the patients in group normal group(P<0.05).Performing multivariable logistic regression on the end point events of patients in 3 months after hospital discharge,hsTn I has statistic difference(P<0.05).Conclusion:DCM patients with HF decompensation cTnT concentration elevated in patients with HF,with 3 months endpoint rate high,to 3 months in the end event independent prediction value.