超敏肌钙蛋白T和红细胞分布宽度在评估慢性心力衰竭中的临床意义  

The clinical significance of high sensitive troponin T and red blood cell distribution width in patients with chronic heart failure

作　　者：曹建红[1] 范慧敏[1] 于萍[1] 奚晓玲[1] 胡昊[1] 

机构地区：[1]同济大学附属上海市东方医院心衰专科,上海市200120

出　　处：《中国心血管病研究》2015年第9期810-813,共4页Chinese Journal of Cardiovascular Research

基　　金：上海市卫计委课题（项目编号：201440046）：同济大学附属上海市东方医院朝阳人才计划（项目编号：DFZY一17）

摘　　要：目的 探讨超敏肌钙蛋白T（hs-TnT）和红细胞分布宽度（RDW）与慢性心力衰竭（CHF）患者心功能变化的关系及其可能的机制.方法 选择396例CHF患者为研究对象,每位患者均接受血常规、血生化、心脏彩色多普勒超声、12导同步体表心电图检测.根据NYHA分级分为3组,各组之间进行相关指标比较.结果 随着NYHA心功能分级逐渐升高,CHF患者左室舒张末期内径（LVEDD）逐渐增大,hs-TnT值及RDW值呈逐渐增加趋势,且各组间差异有统计学意义：hs-TnT（0.018±0.870）μg/L比（0.023 ±0.490） μg/L比（0.029±0.730）μg/L;RDW（14.02±1.23）％比（14.65±1.86）％比（14.96±1.37）％;LVEDD （57.61±6.25）mm比（63.91 ±8.97）mm比（69.01±8.07）mm（P均＜0.01）.经相关性分析,hs-TnT与NYHA及LVEDD呈正相关（r=0.523,0.639,P＜0.01）,RDW与NYHA及LVEDD呈正相关（r=0.313,0.487,P＜0.01）,hs-TnT与RDW呈正相关（r=0.652,P＜0.01）.结论 Hs-TnT和RDW水平与慢性心力衰竭严重程度之间存在显著的相关性：慢性心力衰竭患者的心功能越差,左心室重构程度越重,则hs-TnT水平和RDW水平越高.Hs-TnT和RDW可作为评估慢性心力衰竭严重程度的有力指标.Objective To study the clinical significance of high sensitive troponin T and red blood cell distribution width in patients with chronic heart failure and explore its possible mechanism. Methods Throe hun- dred and ninety-six patients were included in our study. Each patient received the examinations of blood routine, blood biochemistry, electrocardiogram and echocardiography. According to the NYHA, the patients were divided into groups I] , III, IV, respectively. The groups were compared with each other. Results According to a progres- sive increase in NYHA, hs-TnT level and RDW level and LVEDD were increased gradually, hs-TnT （0.018± 0.870）μg/L vs. （0.023±0.490）μg/L vs. （0.029±0.730）μg/L, RDW （14,02±1.23）% vs. （14.65±1.86）% vs. （ 14.96± 1.37 ）%, LVEDD （ 57.61±6.25 ）mm vs. （ 63.91 ±8.97 ）mm vs. （ 69.01 ±8.07 ）mm. There was significant difference among the three groups （P〈0.01）. Hs-TnT level and RDW level correlated positively with NYHA and LVEDD（r=0.523,0.639,P〈0.01 ）. In chronic heart failure, there were significant correlation between hs-TnT level and RDW level （r=0.652, P〈0.01 ）. Conclusion Hs-TnT and RDW correlated with the change of cardiac function in patients with chronic heart failure. With a progressive increase in NYHA, hs-TnT level and RDW level and LVEDD increased gradually. Hs-TnT level and RDW level are strong factors with chronic heart failure.

关 键 词：慢性心力衰竭 超敏肌钙蛋白 红细胞分布宽度 

分 类 号：R541.6[医药卫生—心血管疾病]