探讨hs-cTnT、BNP、CK-MB、LDH在心力衰竭早期诊断中的临床价值  

Clinical Value of hs-cTnT,BNP,CK-MB and LDH in Early Diagnosis of Heart Failure

作　　者：林小金 LIN Xiaojin(Department of Clinical Laboratory,Lianjiang Hospital of Traditional Chinese Medicine,Fuzhou,Fujian 350500,China)

机构地区：[1]连江县中医院检验科,福建福州350500

出　　处：《中国医药指南》2025年第6期63-65,共3页Guide of China Medicine

摘　　要：目的探析高敏肌钙蛋白T(hs-cTnT)、脑钠肽(BNP)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)对早期诊断心力衰竭(HF)患者的作用。方法选取2023年3月至2024年4月本院收治的HF患者68例,设为观察组,再选取同时期内在本院行体检的健康者68名,设为对照组。两组均接受hs-cTnT、BNP、CK-MB、LDH检测。根据美国纽约心脏病学会心力衰竭程度分级(NYHA)对观察组的HF患者进行分级(Ⅰ~Ⅱ级、Ⅲ~Ⅳ级),并对患者进行为期半年的随访调查,观察HF患者随访期间有无发生不良心血管事件(MACE),根据有无发生MACE将其分为两组(MACE发生组与未发生组)。对比HF患者与健康体检者、不同心功能等级的HF患者的hs-cTnT、BNP、CK-MB、LDH指标水平,并分析hs-cTnT、BNP、CK-MB、LDH指标对HF患者预后是否发生MACE的评估意义。结果观察组HF患者的hs-cTnT、BNP、CK-MB、LDH指标分别高于对照组健康者,且心功能Ⅰ~Ⅱ级的HF患者hs-cTnT、BNP、CK-MB、LDH指标水平低于心功能Ⅲ~Ⅳ级患者(P<0.05);在针对HF患者进行为期半年的随访调查中,发现MACE发生组与MACE未发生组在心功能分级与hs-cTnT、BNP、CK-MB、LDH指标对比上存在统计学意义(P<0.05)。结论hs-cTnT、BNP、CK-MB、LDH的应用对于区分HF患者和健康者有显著应用价值,且有助于判断心功能等级,并对HF患者预后质量有一定预测价值。Objective To explore the application of high-sensitivity troponin T(hs-cTnT),Brain natriuretic peptide,(BNP),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)in the early diagnosis of heart failure(HF)patients.Methods Sixty-eight patients with HF admitted to our hospital from March 2023 to April 2024 were selected as the observation group,and 68 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.hs-cTnT,BNP,CK-MB and LDH were detected in both groups.HF patients in the observation group were classified according to the New York Heart Association(NYHA)classification of heart failure(gradeⅠ-ⅡandⅢ-Ⅳ),and patients were followed up for half a year.The HF patients were observed for major adverse cardiovascular events(MACE)during the follow-up period,and were divided into two groups(MACE occurrence group and non-occurrence group)according to the occurrence of MACE.The levels of hs-cTnT,BNP,CK-MB and LDH indexes in HF patients were compared with healthy subjects and HF patients with different cardiac function grades,and the significance of hs-cTnT,BNP,CK-MB and LDH indexes in evaluating the prognosis of HF patients with MACE was analyzed.Results The hs-cTnT,BNP,CK-MB and LDH indexes of HF patients in observation group were higher than those of healthy controls,and the hs-cTnT,BNP,CK-MB and LDH indexes of HF patients with cardiac function gradeⅠtoⅡwere lower than those of patients with c-ardiac function gradeⅢtoⅣ(P<0.05).In a six-month followup survey of HF patients,it was found that there was statistical significance in cardiac function grading and hs-cTnT,BNP,CK-MB and LDH indexes between the MACE group and the non-MACE group(P<0.05).Conclusions The application of hs cTnT,BNP,CK-MB,and LDH has significant application value in distinguishing HF patients from healthy individuals,and helps to determine the level of cardiac function.It also has certain predictive value for the prognosis quality of HF patients.

关 键 词：心力衰竭 肌钙蛋白 脑钠肽 心肌酶 

分 类 号：R541.6[医药卫生—心血管疾病]