老年住院患者高敏心肌肌钙蛋白T与心脏结构及功能相关性研究  

Correlation between cardiac structure,function and high-sensitivity cardiac troponin T and in elderly inpatients

作　　者：徐颖[1] 王青[1] 张少景 王杰萍[1] 崔云婧 Xu Ying Wang Qing Zhang Shaojing Wang Jieping Cui Yunjing(Cadre Ward ,Fuxing Hospital ,Captial Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院高干病房,北京100038

出　　处：《中国心血管杂志》2016年第5期380-383,共4页Chinese Journal of Cardiovascular Medicine

基　　金：北京西城区科技计划项目(XCKJJH21326)~~

摘　　要：目的 探讨老年住院患者高敏心肌肌钙蛋白T（hs-cTnT）与超声心脏结构和功能的相关性。方法 采用横断面研究,入选2014年5月至2015年5月期间我院老年内科65岁以上非急性冠脉综合征（ACS）住院患者343例,其中男性251例,女性92例。平均年龄为（81.2±6.5）岁,采血测定hs-cTnT水平并行超声心动图测量心脏结构和功能指标,左室舒张末内径（LVEDD）、左室收缩末内径（LVEDS）、左房前后径（LAD）,室间隔厚度（IVSd）、左室后壁厚度（LVPWD）、左室射血分数（EF）,计算左室质量指数（LVMI）。分析hs-cTnT水平与上述心脏指标的关系。结果 纳入343例老年住院患者中,335例（97.66%）检测出hs-c TnT,hs-cTnT水平在0.003-0.109 ng/ml,中位数为0.013（0.008,0.020）ng/ml。根据hs-cTnT水平将患者分为低值组（≤0.009 ng/ml）,中值组（0.010-0.017 ng/ml）和高值组（≥0.018 ng/ml）。与低值组和中值组比较,高值组患者LAD、LVEDS和LVMI增大,EF值下降（均为P〈0.05）。Spearman相关分析显示,hs-cTnT水平与LVPWD、LVMI、LVEDS、LAD呈正相关,与EF值呈负相关（均为P〈0.05）。多元逐步回归分析显示,hs-cTnT水平与LVMI和EF值独立相关。结论 非ACS老年住院患者,hs-cTnT水平与LVMI和LAD正相关,与EF值负相关。该人群hs-cTnT升高可能与心脏结构及功能异常有关,老年患者ACS诊断需谨慎解读hs-c TnT。Objective To investigate the correlation between cardiac structure, function and high sensitivity cardiac troponin T （ hs-cTnT） in elderly hospitalized patients. Methods In this cross-sectional study,343 non-acute coronary syndrome （ ACS） patients aged 65 years and older were enrolled from May 2014 to May 2015,including 251 males and 92 females with a mean age of 82.1 ＆#177;6.5 years old.Blood hs-cTnT concentrations was tested and echocardiography was performed to measure left ventricular end dilated diameter （ LVEDD ） , left ventricular end systolic diameter （ LVESD ） , left atrium diameter （ LAD ） , interventricular septal （IVSd）,left ventricular posterior wall diameter （LVPWD）,left ventricular ejection fraction （LVEF） and left ventricular mass index （LVMI）.The correlation between hs-cTnT level and cardiac parameters was analyzed. Results In 343 elderly patients,hs-cTnT was detected in 335 cases （97.66%） .The median hs-cTnT levels was 0.013 （0.008,0.020） ng/ml ranging from 0.003 ng/ml to 0.109 ng/ml.The patients were divided into low group （≤0.009 ng/ml）,middle group （0.010-0.017 ng/ml） and high group （≥0.018 ng/ml） based on hs-cTnT levels.Compared with the low group or middle group,LAD, LVESD,and LVMI were increased and LVEF was decreased in the high group （ all P〈0.05 ） .Spearman correlation analysis showed that hs-cTnT levels were positively correlated with LVPWD,LVMI,LVEDS and LAD,and negatively correlated with EF value （ all P〈0.05 ） .Multiple stepwise regression analysis showed hs-cTnT level was independently related to LVMI and LVEF. Conclusions The level of hs-cTnT was positively correlated with LVMI and LAD, and negatively correlated with LVEF in elderly hospitalized patients with non-ACS.Elevated hs-cTnT level may be associated with cardiac structure and dysfunction.It is necessary to carefully interpret hs-cTnT in diagnosis of ACS of elderly patients.

关 键 词：老年人 肌钙蛋白T 超声心动描记术 

分 类 号：R54[医药卫生—心血管疾病]