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目的探讨慢性心力衰竭(心衰)患者血清胆红素和心肌肌钙蛋白T(cTnT)异常的变化规律及其临床意义。方法慢性心衰患者70例,按心功能分级分为2组心功能Ⅲ~Ⅳ级组,30例;心功能Ⅱ级组,40例。另选取30例心功能正常者作为正常对照组。所有病例入院当天或第2天检测血清胆红素(包括总胆红素和直接胆红素)和cTnT,其中心功能Ⅲ~Ⅳ级患者治疗1周后复查血清胆红素和cTnT。结果与心功能Ⅱ级患者及正常对照组比较,心功能Ⅲ~Ⅳ级患者,血清总胆红素、直接胆红素水平和TnT阳性率明显升高(P<0.01);经有效纠正心衰治疗后,血清总胆红素、直接胆红素水平及cTnT阳性率明显降低(P<0.01)。心功能Ⅱ级患者血清总胆红素、直接胆红素水平及cTnT阳性率与正常对照组比较差异无统计学意义。结论对慢性心衰患者动态观察血清胆红素及cTnT有助于判断心衰严重程度,评估治疗效果及预后。
Objective To investigate the changes of serum bilirubin and cardiac troponin T (cTnT) abnormalities in patients with chronic heart failure (CHF) and its clinical significance. Methods Seventy patients with chronic heart failure were divided into two groups according to cardiac function grade Ⅲ ~ Ⅳ group, 30 cases; heart function Ⅱ group, 40 cases. Another 30 normal heart function as a normal control group. Serum bilirubin (including total bilirubin and direct bilirubin) and cTnT were detected in all cases on the day of admission or on the second day. Serum bilirubin and cTnT were examined in patients with central function Ⅲ ~ Ⅳ after one week of treatment. Results The levels of total bilirubin, direct bilirubin and TnT in patients with grade Ⅲ ~ Ⅳ cardiac function were significantly higher than those in grade Ⅱ patients with cardiac dysfunction and normal control group (P <0.01). After effective correction of heart failure After treatment, serum total bilirubin, direct bilirubin and cTnT positive rate was significantly lower (P <0.01). Serum total bilirubin, direct bilirubin and cTnT positive rate in patients with cardiac function grade Ⅱ were not significantly different from those in normal control group. Conclusion The dynamic observation of serum bilirubin and cTnT in patients with chronic heart failure can help determine the severity of heart failure and evaluate the therapeutic effect and prognosis.