心力衰竭患者血清肌钙蛋白浓度与心脏重塑及心肝肾功能的关系及意义  

Relationship between serum cardiac troponin concentration and cardiac remodeling,cardiac function,renal function,liver function in elderly patients with chronic heart failure

作　　者：郁鹏[1,2] 房加雄 姬乐[1,2] 于慧春[2] 郝媛媛[2] 李贺[3] 

机构地区：[1]天津中医药大学,天津300073 [2]天津市西青医院 [3]天津市武警后勤学院附属医院

出　　处：《临床医学》2016年第7期1-5,共5页Clinical Medicine

摘　　要：目的研究老年心力衰竭(HF)患者血清肌钙蛋白(c Tn)浓度与心脏重塑及心、肝、肾功能变化的关系。方法连续观察150例住院治疗的不同c Tn浓度的HF患者心脏重塑及心、肝、肾脏功能变化,分析这些变化与c Tn浓度间关系。结果随c Tn浓度升高,心脏重塑更加明显,心功能、左心室射血分数(LVEF)明显降低,氨基末端脑钠肽前体(NT-pro BNP)呈上升趋势,肾功能呈减退趋势,尿酸、尿素水平显著升高,肝功能无明显变化。结论 HF患者血清c Tn浓度的变化与心肾功能下降及心脏重塑有相关关系,这些变化反映了不同的病理生理状态,与心脏血流动力学异常、肾脏交感神经(SNS)、肾素-血管紧张素-醛固醇系统(RAAS)激活、氧化应激等相关。在HF进展过程中,肝功能会受到不同程度的影响,而本组试验结果与传统认识不同。结合HF患者不同c Tn浓度与心脏结构及心、肝、肾功能的相关性分析,进一步认识HF的病理生理过程,对于选择正确的治疗对策、改善预后有特殊意义。Objective To investigate the relationship between serum cardiac troponin concentration and cardiac remodeling,cardiac function,renal function,liver function in elderly patients with chronic heart failure. Methods A total of 150 consecutive,chronic HF patients were divided into three groups according to troponin concentration. Serum cardiac troponin I,renal,liver function tests,serum uric acid were measured,and LVEF was determined by echocardiography. Results As the cardiac troponin concentration increased,cardiac remodeling was more obvious,cardiac function was significantly decreased,and NTpro BNP levels were increased,renal function showed a decreasing trend,uric acid,urea levels were significantly increased,and there was no significant change in liver function. Conclusion The changes of serum cardiac troponin concentrations in patients with HF are correlated with decreased cardiac and renal function and cardiac remodeling,which reflecting hemodynamic disturbance,sympathetic nerve system and neurohormonal activation. In the progress of HF,liver function will be affected by different degrees,and the result of this experiment is different from traditional understanding. Combined with the correlation analysis of cardiac structure with heart function of patients with HF,and further understanding of the pathophysiological process of HF,it is of special significance to select the correct treatment and improve prognosis.

关 键 词：心力衰竭 肌钙蛋白 心脏重塑 心肾肝功能 

分 类 号：R541.6[医药卫生—心血管疾病]