Cardiac Troponin Levels In Patients With Chronic Renal Disease: The Clinical Observation

Objective:Cardiovascular disease is one of the important causes of death in chronic renal failure(CRF)with long-term dialysis patients.It is very important that the cardiovascular diseases can be diagnosed earlier to reduce mortality in hemo- dialysis patients.However,It is very difficult to diagnose because the clinical symptom of myocardial damage of CRF is not typical.In recent years,cardiac troponin T and cardiac troponin I are found more specific and high sensitive,which has been taken as a laboratory diagnosis of myocardial injury,including a minor myocardial damage.This study attempts to observe serum cardiac troponin T (cTnT),cardiac troponin I (cTnI) of the clinical patients with chronic renal failure, and compared to creatine kinase -MB(CK-MB),and hopefully find more earlier and more reliable indicators to detect myocardial damage in patients in order to reduce the incidence of cardiovascular events.Methods:Selecting 111 cases of in-patients and out-patients of our hospital from December 2007 to December 2008.The group were divided according to:①the normal renal function or not.②dialysis or non-dialysis in CRF.③the clinical symptom,such as chest tightness,shortness of breath, palpitations,angina or not in dialysis patients.④diabete or not in dialysis patients.⑤the time of dialysis in dialysis patients.⑥the age of dialysis in dialysis patients.Dialysis patients blood was taken pre-dialysis, other patients in the morning, to detect serum cTnT, cTnI, CK-MB, create- nine (SCr),hemoglobin concentration (Hb),albumin concentration (ALB).Results:①Compared with normal renal function group,the average serum cTnT,cTnI levels of CRF group were significantly higher than normal renal function(P<0.05),the average level of serum CK-MB was no signi- ficant difference (P>0.05).②Compared with non-dialysis patients,the serum cTnT, cTnI levels and percentage of dialysis patients were significantly higher(P<0.05),the ave- rage level of serum CK-MB was no significant difference (P>0.05).③In dialysis group the average serum levels of cTnT,cTnI,CK-MB levels and percentage of having clinical symptom were significantly higher than asymptomatic patients(P<0.05);However,average levels of serum cTnT of 18 cases (58.1%) and average levels of serum cTnI of 1cases (3.2%)were higher than normal levels.④In diabetic nephropathy group the average serum cTnT, cTnI levels were significantly higher than non diabetic patients.(P <0.05).⑤The mean serum cTnT,cTnI levels were no correlation with the age, dialysis duration,SCR,HB,ALB(P>0.05).⑥compared with diylysis patients with the age≤65, the average level serum cTnT,cTnI and CK-MB of the age >65 is not obviously elevated.Conclution:1.The average serum cTnT and cTnI levels of CRF patients are higher than the normal renal function.Compared to serum CK-MB,serum troponin can be prompted to myocardial damage earlier.the serum cTnT is more higher sensitive..the serum cTnI is more specific.2.The average serum cTnT and cTnI levels of dialysis patients are higher than the non-dialysis among chronic renal failure patients;In dialysis group the average serum levels of cTnT,cTnI,CK-MB levels and percentage of having clinical symptom were significantly higher than asymptomatic patients.but the average serum cTnT level of asymptomatic is elevated. In diabetic nephropathy group the average serum cTnT, cTnI levels were significantly higher than non diabetic patients...