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目的探讨维持性血液透析(MHD)患者血清心肌肌钙蛋白T(cTnT)和C反应蛋白(CRP)对其心脑血管疾病及死亡的预测价值。方法选择在北京医院进行维持性血液透析的患者106例。检测透析前血清cTnT、CRP、Scr、白蛋白等,计算Kt／V,并行心电图检查。以第 1次取血时间为研究的开始,记录随访期间患者的死亡情况及发生的心脑血管事件。结果 106 例MHD患者中,血清cTnT阳性28例(26．42％),血清CRP阳性32例(30．19％),2者均阳性16 例(15．09％)。平均随访(16．59±9．44)月,随访期间死亡22例(20．75％),发生心脑血管事件38 例(35．85％)。Logistic回归分析显示血清cTdT水平与CRP及Scr显著相关;血清CRP水平与年龄、cTnT及Kt／V显著相关。血清cTnT阳性组的病死率和心脑血管事件发生率比阴性组显著上升,P值分别为0．001和0．023。血清CRP阳性组与阴性组也表现同样结果。2者均阳性组与其他3组相比,病死率和心脑血管事件发生率也显著上升。生存分析显示,2者的单独阳性和联合阳性都对生存有明显影响。结论维持性血液透析无急性冠脉综合征的患者中,部分患者血清 cTnT水平升高。血清cTnT阳性与血清CRP及Scr水平相关。血清cTnT及CRP阳性组总病死率及心脑血管事件发生率均明显高于2者的阴性组。
Objective To investigate the predictive value of serum cardiac troponin T (cTnT) and C-reactive protein (CRP) in patients with maintenance hemodialysis (MHD) for cardiovascular and cerebrovascular diseases and death. Methods 106 patients with maintenance hemodialysis in Beijing Hospital were selected. Pre-dialysis serum cTnT, CRP, Scr, albumin, calculated Kt / V, parallel ECG. The first time to take blood as the beginning of the study, record the patient’s death during follow-up and the occurrence of cardiovascular events. Results Of the 106 patients with MHD, 28 (26.42%) had positive serum cTnT and 32 (30.19%) had positive serum CRP. Both of them were positive in 16 cases (15.09%). During the mean follow-up (16.59 ± 9.44) months, 22 patients (20.75%) died during the follow-up period and 38 patients (35.85%) had cardiovascular and cerebrovascular events. Logistic regression analysis showed that serum cTdT levels were significantly correlated with CRP and Scr; serum CRP levels were significantly associated with age, cTnT and Kt / V. Serum cTnT-positive mortality and cardiovascular events than the negative group significantly increased, P values were 0.001 and 0.023. Serum CRP positive group and negative group also showed the same result. 2 were positive group compared with the other three groups, the incidence of mortality and cardiovascular events also increased significantly. Survival analysis showed that both single positive and combined positive have a significant impact on survival. Conclusion In patients with maintenance hemodialysis without acute coronary syndrome, some patients have elevated serum cTnT levels. Serum cTnT positive and serum CRP and Scr levels. Serum cTnT and CRP positive group total mortality and cardiovascular events were significantly higher than the two negative group.