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目的：通过研究原发性高血压（高血压病）患者运动负荷前后血清肌钙蛋白Ｔ（ＴｎＴ）的变化，拟间接推断高血压病患者合并心脏微血管及大血管病变的可能性。方法：对５４例高血压病患者（ＥＴ）进行次极量运动平板试验，并与冠心病患者及正常人进行对照，采用固相酶联免疫法进行运动前、后（６分钟及２４小时）血清ＴｎＴ的测定。对运动试验阳性及心电图有Ｔ波变化的高血压病、冠心病患者进行冠状动脉造影。结果：在运动试验阴性患者中，有Ｔ波改变的高血压病患者（冠状动脉造影阴性为９２％，阳性为８％）血清ＴｎＴ在运动后均高于运动前（Ｐ＜０．０５）。无Ｔ波变化患者仅于运动后６分钟时血清ＴｎＴ增高，２４小时血清ＴｎＴ恢复正常。高血压病患者运动试验阳性中（冠状动脉造影阴性为２６％，阳性为７４％）及冠心病、心绞痛组，运动负荷后血清ＴｎＴ６分钟及２４小时均有明显改变（Ｐ＜０．０１及Ｐ＜０．０５），并随着冠状动脉狭窄程度的加重，运动后血清ＴｎＴ值随之增高，呈正相关。结论：高血压病患者运动负荷后血清ＴｎＴ水平的检测有助于间接推断其心肌及冠状动脉受损的情况。
Objective: To investigate the possible changes of cardiac troponin T (TnT) before and after exercise stress in patients with essential hypertension (hypertension), and to indirectly infer the possibility of hypertension and macrovascular complications in hypertensive patients. Methods: Fifty-four patients with essential hypertension (ET) were subjected to submaximal exercise treadmill test and compared with patients with coronary heart disease and normal subjects. Before and after exercise (6 minutes and 24 hours) Determination of serum TnT. Coronary artery angiography was performed on hypertensive patients with coronary artery disease and positive T-wave changes in electrocardiogram. Results: In patients with negative T exercise, the TnT in patients with hypertensive disorder with T wave change (92% of coronary angiography was negative and 8% of positive) was higher than that before exercise (P <0.05). No T wave changes in patients with exercise only 6 minutes after the serum TnT increased 24 hours serum TnT returned to normal. Hypertension patients with exercise test positive (coronary angiography was negative 26%, positive 74%) and coronary heart disease, angina pectoris, exercise load serum TnT6 minutes and 24 hours were significantly changed (P <0.01 and P <0.05), and with the severity of coronary artery stenosis, serum TnT value increased after exercise, was positively correlated. Conclusion: The detection of serum TnT level after exercise stress in hypertensive patients may help to indirectly infer the damage of myocardial and coronary artery.