老年男性稳定性冠心病患者高敏肌钙蛋白T与N末端B型利尿钠肽前体的相关性  

Relationship between High-Sensitivity Troponin T and N-Terminal B-Type Natriuretic Peptide in Elderly Male Patients with Stable Coronary Heart Disease

作　　者：李冬云[1] 高扬 刘宏伟[3] 白永怿[3] 王凡[3] 曹瑞华[1] LI Dongyun;GAO Yang;LIU Hongwei;BAI Yongyi;WANG Fan;CAO Ruihua(The First Health Care Department,The Second Medical Centre,Chinese PLA General Hospital,Beijing 100853,China;Clinic of No.55 Retired Cadre Rest Center,Haidian District,Beijing Garrison,Beijing 100036,China;Department of Cardiology,The Second Medical Centre,Chinese PLA General Hospital,National Clinical Research Center for Geriatric Diseases,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心保健一科,北京市100853 [2]北京卫戍区海淀第五十五离职干部休养所门诊部,北京市100036 [3]解放军总医院第二医学中心心血管内科、国家老年疾病临床医学研究中心,北京市100853

出　　处：《中国分子心脏病学杂志》2022年第5期4911-4915,共5页Molecular Cardiology of China

基　　金：军队保健专项课题重点项目(18BJZ32);中央保健课题重点项目(2020ZD05)。

摘　　要：目的探讨老年男性稳定性冠心病患者高敏肌钙蛋白T(hsTnT)与N末端B型利尿钠肽前体(NT-proBNP)的相关性。方法选择2018年3—8月在解放军总医院第二医学中心和国家老年疾病临床医学研究中心门诊查体并诊断为稳定性冠心病的老年男性患者755例进行回顾性分析。其中356例hsTnT<14 ng/L(低hsTnT水平组),399例hsTnT≥14 ng/L(高hsTnT水平组)。收集两组患者的一般临床资料,计算估算的肾小球滤过率(eGFR),并进行比较,同时分析hs-TnT与NT-proBNP的相关性。结果与低hsTnT水平组患者比较,高hsTnT水平组患者eGFR水平较低,NT-proBNP水平较高,且差异均有统计学意义(P<0.01)。Pearson相关分析结果显示,年龄、hs-TnT与NT-proBNP呈正相关(r=0.073,P=0.045;r=0.540,P<0.001),舒张压、eGFR与NT-proBNP呈负相关(r=-0.111,P=0.005;r=-0.241,P<0.001)。多元线性回归分析结果显示,在校正了多个传统心血管危险因素后,hs-TnT与NT-proBNP呈正相关(β=0.958,95%CI:0.821~1.095,P<0.001),且冠心病合并糖尿病组患者hs-TnT与NT-proBNP呈更显著的正相关(β=1.111,95%CI:0.958~1.264,P<0.001)。结论老年男性稳定性冠心病患者心肌损伤标志物hs-TnT与心功能指标NT-proBNP呈独立正相关,且在冠心病合并糖尿病患者中的相关性更显著。Objective To investigate the relationship between high-sensitivity troponin T(hsTnT)and N-terminal B-type natriuretic peptide(NT-proBNP)in elderly male patients with stable coronary heart disease.Methods A total of 755elderly male patients with stable coronary heart disease who received health examination in the Second Medical Centre and the National Clinical Research Center for Geriatric Diseases of Chinese PLA General Hospital for Geriatric Diseases from March to August in 2018 were enrolled in this study.According to the level of hsTnT,the subjects were divided into hsTnT<14 ng/L(low hsTnT group,n=356)and hsTnT≥14 ng/L(high hsTnT group,n=399).Plasma NT-proBNP and estimated glomerular filtration rate(eGFR)were evaluated.Results Compared with low hsTnT group,the level of eGFR was lower in high hsTnT group,while the level of NT-proBNP was significantly higher(P<0.01).The age and hsTnT were negatively related with NT-proBNP(r=0.073,P=0.045;r=0.540,P<0.001)while the diastolic blood pressure(DBP)and eGFR levels were positively related with NT-proBNP(r=-0.111,P=0.005;r=-0.241,P<0.001).Multivariate linear regression analysis showed that after adjusting for traditional cardiovascular risk factors,hsTnT was positively correlated with NT-proBNP(β=0.958,95%CI:0.821-1.095,P<0.001),and the correlation was strengthened in coronary heart disease with diabetes mellitus group(β=1.111,95%CI:0.958-1.264,P<0.001).Conclusions In the elderly male patients with coronary heart disease,serum hsTnT was positively correlated with NT-proBNP,and the correlation was strengthened in the subgroup of coronary heart disease with diabetes mellitus.

关 键 词：高敏肌钙蛋白T N末端B型钠尿肽前体 老年人 冠心病 男性 

分 类 号：R541.4[医药卫生—心血管疾病]