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目的:观察血清心肌肌钙蛋白T(cTnT)水平与充血性心力衰竭(CHF)患者预后的关系。方法:选择265例CHF患者和75例健康者,应用电化学发光免疫法检测血清cTnT水平。结果:CHF患者血清cTnT为(0.181±0.536)μg/L,健康对照者为(0.003±0.001)μg/L(P<0.01)。105例左室射血分数(LVEF)≤35％者,cTnT水平为(0.31±0.22)μg/L,160例LVEF>35％者,cTnT为(0.07±0.05)μg/L(P<0.01)。LVEF值与cTnT水平呈负相关(r=0.493,P<0.01)。心功能(NYHA)为Ⅰ、Ⅱ、Ⅲ、Ⅳ级者,其血清cTnT分别为(0.06±0.02)、(0.11±0.10)、(0.19±0.20)、(0.38±0.21)μg/L。随访6个月,观察终点为心力衰竭死亡。血清cTnT≥0.1μg/L55例,失访2例,死亡17例,病死率为32.00％;cTnT<0.1～≥0.05 μg/L 86例,失访3例,死亡8例,病死率为9.64％;cTnT<0.05μg/L 124例,失访2例,死亡3例,病死率为2.46％。结论:CHF患者血清cTnT水平升高,其升高程度与心力衰竭严重程度相平行,并预示患者预后不良。
Objective: To observe the relationship between serum cardiac troponin T (cTnT) level and the prognosis of patients with congestive heart failure (CHF). Methods: A total of 265 patients with CHF and 75 healthy controls were selected. Serum cTnT levels were measured by chemiluminescence immunoassay. Results: Serum cTnT was (0.181 ± 0.536) μg / L in CHF patients and (0.003 ± 0.001) μg / L in healthy controls (P <0.01). CTnT was (0.07 ± 0.05) μg / L (P <0.01) in 105 patients with LVEF ≤35%, cTnT level was (0.31 ± 0.22) μg / L, 160 patients with LVEF> 35% . LVEF was negatively correlated with cTnT (r = 0.493, P <0.01). The cardiac function (NYHA) was grade Ⅰ, Ⅱ, Ⅲ and Ⅳ, the serum cTnT levels were (0.06 ± 0.02), (0.11 ± 0.10), (0.19 ± 0.20) and (0.38 ± 0.21) μg / L, respectively. Followed up for 6 months, the end of the observation of heart failure death. Serum cTnT≥0.1μg / L 55 cases, 2 cases were lost, 17 cases died, the case fatality rate was 32.00%; cTnT <0.1 ~> 0.05μg / L 86 cases, 3 cases were lost to follow-up, 8 cases died, the case fatality rate was 9.64% ; cTnT <0.05μg / L 124 cases, 2 cases were lost to follow-up, 3 died, the case fatality rate was 2.46%. CONCLUSIONS: Serum cTnT levels are elevated in patients with CHF, and their elevation is in parallel with the severity of heart failure, indicating a poor prognosis.