目的:探讨扩张型心肌病(DCM)患者心力衰竭(HF)失代偿期肌钙蛋白T(cTnT)浓度与HF严重程度及出院3个月预后的关系.方法:HF失代偿期住院的DCM患者219例,入院后测定血浆cTnT浓度,进行常规实验室检查及超声心动图检查.将患者分成cTnT≤0.05ng/ml组(正常组119例)和cTnT>0.05ng/ml组(升高组100例),分析两组患者入院时的一般资料、检查及出院后3个月内的终点事件(因心力衰竭再住院及心源性死亡).结果:入院时升高组患者脑利钠肽前体(NT-proBNP)比正常组患者更高(P<0.05)、射血分数更低(P<0.05)、左室舒张末期内径更大(P<0.05)、NYHA分级达Ⅲ、Ⅳ级的比例更高(P<0.05);升高组患者3个月的终点事件发生率明显高于正常组患者(P<0.05);对患者3个月内终点事件的发生做多因素逻辑回归发现cTnT有统计学意义(P<0.05).结论:DCM患者HF失代偿期cTnT浓度升高提示患者HF程度更严重、患者3个月内终点事件的发生率更高,对3个月内终点事件发生有独立的预测价值.%Objective: To investigate the relationship between the concentration of T (cTnT) and the severity of HF and the prognosis in patients with dilated cardiomyopathy (DCM). Methods:219 cases of DCM who were hospitalized in HF were divided into two group,the patients were divided into the cTnT≤0.05ng/ml group (normal group)and cTnT>0.05ng/ml group(higher group). Analysis of the two groups of patients at the time of admission to the general information, check and the end of the 3 months after discharge(hospitalization for heart failure again and cardiac death). Results:Brain natriuretic peptide (NT proBNP) in group higher group was Higher than that of normal group group of patients admitted to hospital patients(P <0.05), shoot ejection fraction lower (P <0.05), left ventricular end diastolic diameter greater (P <0.05), NYHA class of Ⅲ, Ⅳ ratio higher (P <0.05); patients in group higher group and 3 months of end point occurrence rate was significantly higher than that of the patients in group normal group (P<0.05). Performing multivariable logistic regression on the end point events of patients in 3 months after hospital discharge,hs-TnI has statistic difference(P < 0.05). Conclusion:DCM patients with HF decompensation cTnT concentration elevated in patients with HF, with 3 months endpoint rate high, to 3 months in the end event independent prediction value.
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