Cardiac troponins: outcome predictors in hemodialysis patients
Cardiac troponins: outcome predictors in hemodialysis patients
复制标题
心肌肌钙蛋白：血液透析患者的结果预测因素
DOI：
10.1007/s10047-009-0472-5
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发表时间：
2009
影响因子：
1.3
通讯作者：
B. Stojimirović
中科院分区：
文献类型：
--
作者：
D. Petrovic;B. Stojimirović
心血管疾病是血液透析（HD）患者死亡的主要原因。心肌肌钙蛋白（cTnT和cTnI）是心肌损伤的指标。本研究的目的是评估无急性冠状动脉综合征时血清cTn升高的患病率，确定总死亡率和心血管死亡率，并研究cTnT和cTnI在2年随访期间对HD患者预后的可能预测价值。研究纳入115例患者（男性71例，女性44例），平均年龄53.30±12.17岁，接受常规HD治疗4.51±4.01年，平均HD充分性（Kt/Vsp）为1.17±0.23。37.39%的患者血清cTnT浓度升高，11.30%无急性冠脉综合征症状或体征的HD患者血清cTnI浓度升高。平均2年死亡率为13.74%，平均2年心血管死亡率为8.51%。血清cTnT水平高于0.10 ng/ml的患者的总体生存率和心血管生存率明显低于血清cTnT水平低于0.10 ng/ml的患者。血清cTnI水平大于0.15 ng/ml的患者总体生存率和心血管生存率明显低于血清cTnI水平小于0.15 ng/ml的患者。在常规HD患者中，cTn水平是重要的预后预测指标。
Cardiovascular diseases represent the main cause of death in hemodialysis (HD) patients. Cardiac troponins (cTnT and cTnI) are indicators of myocardial damage. The aims of this study were to assess the prevalence of increased serum cTn in the absence of acute coronary syndrome, to determine overall and cardiovascular mortality rates, and to investigate the possible predictive values of cTnT and cTnI on the outcome in HD patients over a 2-year follow-up period. The study included 115 patients (71 men and 44 women) with an average age of 53.30 ± 12.17 years who had undergone regular HD for 4.51 ± 4.01 years and had a mean HD adequacy (Kt/Vsp) of 1.17 ± 0.23. Increased serum cTnT concentration was found in 37.39% of patients and elevated serum cTnI concentration was present in 11.30% of HD patients without symptoms or signs of acute coronary syndrome. The average 2-year mortality rate was 13.74% and the average 2-year cardiovascular mortality rate was 8.51%. Patients with serum cTnT levels greater than 0.10 ng/ml had significantly lower overall and cardiovascular survival rates than patients with serum cTnT levels of less than 0.10 ng/ml. Patients with serum cTnI levels greater than 0.15 ng/ml had significantly lower overall and cardiovascular survival rates than patients with serum cTnI of less than 0.15 ng/ml. In patients on regular HD, cTn levels are significant outcome predictors.