摘要
目的研究心肌肌钙蛋白I(cTnI)自身抗体对缺血性心肌病患者预后及生活质量的影响。方法连续收集2016年6月至2017年6月因缺血性心肌病入河南省人民医院住院的患者,同期收集健康体检者作为对照组,检测其血清肌钙蛋白I自身抗体。6个月后对所有患者进行门诊或电话随访,随访内容包括死亡、再入院次数、器械治疗(CRT-P或CRT-D)或心脏移植,并采用生活质量调查表(SF-36)进行生活质量调查。分析血清肌钙蛋白I自身抗体对患者预后及生活质量的影响。结果共入组127例缺血性心肌病患者,其血清cTnI自身抗体检测值较健康对照组明显增高[(0.55±0.24)vs(0.46±0.07),P<0.05]。以大于0.67作为阳性标准,127例缺血性心肌病患者检出26例患者血清cTnI自身抗体阳性,阳性率为20.5%。6个月后进行门诊或电话随访,失访9例,失访率7%,共完成随访118例,其中cTnI自身抗体阳性24例。与抗cTnI自身抗体阴性患者相比,抗cTnI自身抗体阳性患者半年内再入院次数明显增多[(1.42±0.79)vs(0.30±0.55),P<0.01],生理机能明显降低[(56±19.4)vs(67±20.8),P=0.032]。对不同射血分数患者进行分组分析,射血分数降低的cTnI自身抗体阳性组患者生理机能、精力以及社会功能均明显差于阴性组,而在射血分数保留和中间值患者中cTnI自身抗体阳性与阴性两组之间生活质量各指标差异无统计学意义。结论在缺血性心肌病患者中抗cTnI自身抗体阳性患者预后和生活质量更差,尤其伴射血分数降低者。
Objective To explore the effect of troponin I(anti-cTnI)autoantibodies on the quality of life and prognosis in patients with ischemic cardiomyopathy.MethodsPatients hospitalized in Henan Provincial People's Hospital for ischemic cardiomyopathy from June 2016 to June 2017 were enrolled.At the same time,physical examiners were selected as the control group.Anti-cTnI autoantibodies were detected in the serum from the patients and control group,which were expressed as the OD value.After six months,all patients were followed up,including death,times of readmission,instrument treatment(CRT-P or CRT-D)or heart transplantation,and quality of life questionnaire(SF-36).The effect of anti-cTnI autoantibodies on the prognosis and quality of life were analyzed.ResultsIn 127 patients with ischemic cardiomyopathy,the OD value of anti-cTnI autoantibodies were significantly higher than that in the control group[(0.55±0.24)vs(0.46±0.07),P<0.05].With a positive standard of more than 0.67,26 patients with ischemic cardiomyopathy were tested positive for anti-cTnI autoantibodies,with a positive rate of 20.5%.After 6 months of outpatient or telephone follow-up,9 patients were lost to follow-up,and 118 patients were followed up,including 24 patients with positive anti-cTnI autoantibodies.Compared with patients with negative anti-cTnI autoantibodies,the times of readmission in patients with positive anti-cTnI autoantibodies increased significantly[(1.42±0.79)vs(0.30±0.55),P<0.01]and the physiological function was decreased significantly[(56±19.4)vs(67±20.8),P=0.032].The physiological function,vitality and social function of patients with reduced ejection fraction in the anti-cTnI autoantibodies positive group were significantly worse than those in the anti-cTnI autoantibodies negative group,but there was no significant difference in quality of life between the anti-cTnI autoantibodies positive and negative groups in the patients with preserved and median ejection fraction.ConclusionsPatients with ischemic cardiomyopathy of seropositivity for anti-cTnI autoantibodies have worse prognosis and quality of life,especially in those with reduced ejection fraction.
作者
李兵
苗豫东
刘晓宇
段红艳
王勇
王留义
Li Bing;Miao Yudong;Liu Xiaoyu;Duan Hongyan;Wang Yong;Wang Liuyi(The General Practice Department of the Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2019年第2期241-246,共6页
Chinese Journal of Emergency Medicine
基金
河南省科技攻关计划项目(182102310524)
河南省医学科技攻关计划项目(201602234).
