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目的研究老年心力衰竭(HF)患者血清肌钙蛋白(c Tn)浓度与心脏重塑及心、肝、肾功能变化的关系。方法连续观察150例住院治疗的不同c Tn浓度的HF患者心脏重塑及心、肝、肾脏功能变化,分析这些变化与c Tn浓度间关系。结果随c Tn浓度升高,心脏重塑更加明显,心功能、左心室射血分数(LVEF)明显降低,氨基末端脑钠肽前体(NT-pro BNP)呈上升趋势,肾功能呈减退趋势,尿酸、尿素水平显著升高,肝功能无明显变化。结论 HF患者血清c Tn浓度的变化与心肾功能下降及心脏重塑有相关关系,这些变化反映了不同的病理生理状态,与心脏血流动力学异常、肾脏交感神经(SNS)、肾素-血管紧张素-醛固醇系统(RAAS)激活、氧化应激等相关。在HF进展过程中,肝功能会受到不同程度的影响,而本组试验结果与传统认识不同。结合HF患者不同c Tn浓度与心脏结构及心、肝、肾功能的相关性分析,进一步认识HF的病理生理过程,对于选择正确的治疗对策、改善预后有特殊意义。
Objective To study the relationship between serum cardiac troponin (cTn) concentration and cardiac remodeling, heart, liver and kidney function in elderly patients with heart failure (HF). Methods The cardiac remodeling, heart, liver and kidney function in 150 hospitalized HF patients with different cTn concentrations were observed continuously. The relationship between these changes and cTn concentration was analyzed. Results With the increase of cTn concentration, cardiac remodeling was more obvious. The cardiac function and left ventricular ejection fraction (LVEF) were significantly decreased. NT-pro BNP was increased and renal function was decreased , Uric acid, urea increased significantly, no significant change in liver function. Conclusions The changes of serum cTn levels in HF patients are related to the decline of heart and kidney function and cardiac remodeling. These changes reflect different pathophysiological states, which are associated with abnormal cardiac hemodynamics, renal sympathetic nerve (SNS), renin - Angiotensin-aldosterone system (RAAS) activation, oxidative stress and so on. In the progress of HF, liver function will be affected to varying degrees, and the test results in this group are different from the traditional understanding. Combined with the analysis of the correlation between different cTn levels and cardiac structure, heart, liver and kidney function in patients with HF, further understanding of the pathophysiological process of HF is of special significance in choosing the correct treatment strategy and improving the prognosis.