老年住院患者高敏肌钙蛋白T水平变化及非缺血因素的影响  

Effect of non-ischemic factors on hs-cTnT in elderly hospitalized patients

作　　者：张少景 王青[1] 徐颖[1] 赵清华[1] 吴薇[1] 

机构地区：[1]首都医科大学附属复兴医院干部保健科,北京100038

出　　处：《中华老年心脑血管病杂志》2014年第8期800-804,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市西城区科技计划项目(XCKJJH201326)

摘　　要：目的了解住院老年患者高敏肌钙蛋白T(hs-cTnT)水平,分析影响hs-cTnT水平的非缺血因素。方法选择老年无急性冠状动脉综合征住院患者670例,按hs-cTnT 3分位水平将患者分为低值组232例、中值组237例和高值组201例,检测hs-cTnT,收集一般资料、N末端B型钠尿肽前体(NT-proBNP)等指标及超声心动图等。结果与低值组和中值组比较,高值组患者男性、糖尿病、慢性肾病、室壁运动异常、年龄、心率、lg白细胞、lg高敏C反应蛋白、lgNT-proBNP、左心室质量指数(LVMI)等明显升高(P<0.05,P<0.01),估算肾小球滤过率(eGFR)、LVEF明显降低(P<0.01)。Spearman分析显示,hs-cTnT与男性(r=0.225,P=0.000)、年龄(r=0.338,P=0.000)、lgNT-proBNP(r=0.394,P=0.000)、eGFR(r=-0.253,P=0.000)、糖尿病(r=0.138,P=0.001)、LVMI(r=0.186,P=0.000)、LVEF(r=-0.261,P=0.000)和心率(r=0.081,P=0.036)相关。结论老年无急性冠状动脉综合征住院患者存在低水平hs-cTnT升高,hs-cTnT与男性、年龄、NT-proBNP、eGFR、糖尿病、LVMI、LVEF及心率相关,提示低水平hs-cTnT升高患者可能预后不佳。Objective To analyze the effect of non-ischemic factors on hs-cTnT in elderly hospitalized patients.Methods Six hundred and seventy elderly hospitalized patients without acute coronary syndrome were divided into low hs-cTnT group（n=232）,moderate hs-cTnT group（n=237）and high hs-cTnT group（n=201）.The patients underwent echocardiography.Their hs-cTnT and NT-proBNP levels were measured.Results The incidence of diabetes mellitus and chronic kidney disease,abnormal ventricular wall motion,age,heart rate,WBC,serum hs-CRP and NT-proBNP level,and LVMI were significantly higher while the eGFR and LVEF were significantly lower in low hs-cTnT group than in moderate hs-cTnT group（P〈0.05,P〈0.01）.Spearman analysis showed that the hs-cTnT level was related with gender（r=0.225）,age（r=0.338）,lgNT-proBNP（r=0.394）,eGFR（r=-0.253）,diabetes mellitus（r=0.138）,LVMI（r=0.186）,LVEF（r=-0.261）and heart rate（r=0.081,P〈0.05,P〈0.01）.Conclusion The hs-cTnT level is slightly higher in elderly hospitalized patients without acute coronary syndrome and is related with gender,age,NT-proBNP,eGFR,diabetes mellitus,LVMI,LVEF and heart rate,indicating that the prognosis of elderly hospitalized patients without acute coronary syndrome is poor.

关 键 词：肌钙蛋白T 急性冠状动脉综合征 心肌缺血 糖尿病 C反应蛋白质 肾小球滤过率 

分 类 号：R541.4[医药卫生—心血管疾病]