非透析慢性肾脏病患者血清中肌钙蛋白I升高的危险因素  

Risk Factors Associated with Increased Serum Levels of Cardiac Troponin I in Nondialysis Patients with Chronic Kidney Disease

作　　者：叶云[1] 蹇在金[1] 胡信群[1] 邓洪波[1] 

机构地区：[1]中南大学湘雅二医院,湖南长沙410011

出　　处：《医学临床研究》2006年第7期1064-1067,共4页Journal of Clinical Research

摘　　要：【目的】观察未透析慢性肾疾病(CKD)患者血清中心肌肌钙蛋白I(cTnI)的临床意义及影响因素。【方法】收集108例非急性冠脉综合征(ACS)的CKD患者(CKD3期30例;DKD4期40例;DKD5期38例)的临床资料。用Logistic回归法分析cTnI增高与各危险因素间的相关性。【结果】25.9%的患者血清cTnI水平高于正常参考值上限。CKD越严重者,cTnI升高者越多(CKD3期5例,DKD4期9例,DKD5期15例,P<0.001)。cTnI的升高与年龄的增大(P<0.01)、糖尿病(P<0.01)、既往心血管疾病(P<0.05)、左室肥厚(LVH)(P<0.01)、肾小球滤过率(GFR)下降(P<0.05)相关,但多因素分析仅年龄是cTnI升高的独立预测因子(P<0.05),而GFR、左室质量指数(LVMI)均不是。【结论】血清cTnI浓度升高在无ACS的透析前CKD患者中较为普遍。其与心血管危险因素、既往冠心病史、LVH、GFR下降相关。但GFR和LVMI不是其独立预测因子。[Objective]To investigate renal function and risk factors associated with increased serum levels of cardiac troponins I （cTnI）in patients with chronic kidney disease（CKD）. [Methods]The clinical data of 108 patients in the absence of acute coronary syndrome（ACS） were studied. Thirty cases were of stage 3（moderate CKD） ,40 stage 4（severe CKD） ,38 stage 5（renal failure）. Patients underwent echocardiography,and cTnI was tested. [Results]Serum cTnI was increased above normal upper limit in 25.9 % of the patients studied. Serum cTnI was more commonly increased in the presence of more severe CKD（5 in stage 3,9 in stage 4, 15 in stage 5, P 〈0. 001）. Increased levels of cTnI were associated with age（ P 〈0.01） ,diabetes（ P 〈0.01）, history of ischaemic heart disease（ P 〈0.05） and left ventricular hypertrophy（LVH） （P〈0.01） and diminished GFR （ P 〈0.05）. In multivariate analysis,age was the only factor independently associated with inceased serum cTnI. There was no adjusted association of increased cTnI with increased left ventricular mass index（LVMI） and diminished GFR. [Conclusion]Increased cTnI concentrations are relatively common in predialysis CKD patients in the absence of ACS： It is associated with cardiovascular risk factors, history of ischaemic heart disease,LVH and diminished GFR. But GFR and LVMI are not independent predicted factors.

关 键 词：肾疾病/血液 肌钙蛋白Ⅰ/血液 危险因素 慢性病 

分 类 号：R692[医药卫生—泌尿科学]