肌炎特发性炎性肌病患者血清中心肌肌钙蛋白 T 升高，而非肌钙蛋白 I。

Serum cardiac troponin T, but not troponin I, is elevated in idiopathic inflammatory myopathies.

机构信息

Rush University Medical Center; and John Stroger, Jr Hospital of Cook County, Chicago, Illinois 60612, USA.

出版信息

J Rheumatol. 2009 Dec;36(12):2711-4. doi: 10.3899/jrheum.090562. Epub 2009 Oct 15.

DOI:10.3899/jrheum.090562

PMID:19833747

Abstract

OBJECTIVE

To study the association of serum cardiac troponin T (cTnT) and cardiac troponin I (cTnI) with creatine kinase (CK) in patients with idiopathic inflammatory myopathies (IIM).

METHODS

We performed a retrospective study on patients with IIM followed by the rheumatology service of a county hospital from 2004 to 2008. Patients with myocardial ischemia and/or with renal failure were excluded. Clinical data including electromyogram, muscle biopsy, and CK, cTnT and cTnI were recorded. Patients who had simultaneous analysis of CK and cardiac troponin (cTnT or cTnI) levels were studied. CK levels were correlated with cTnT and cTnI by chi-square test and Spearman correlation.

RESULTS

We identified 49 patients with IIM (69 observations) who satisfied our inclusion criteria. The primary diagnosis was polymyositis in 23, dermatomyositis in 16, and myositis associated with connective tissue disease in 10 patients. There were 33/49 women with average age 45.8 years. Twenty-eight patients with IIM had simultaneous CK and cTnT values assayed. Of those patients, 18/23 with elevated CK also had elevated cTnT, and 5/5 patients with normal CK levels had normal cTnT levels (p = 0.005). In 41 patients with IIM who had simultaneous CK and cTnI levels assayed, only 1/29 with elevated CK had elevated cTnI, and 12/12 patients with normal CK had normal cTnI (p = 0.5). CK correlated strongly with the cTnT (r = 0.62, p = 0.001) but did not correlate with cTnI.

CONCLUSION

Elevated cTnT, but not cTnI, was highly associated with CK in patients with IIM despite the absence of myocardial ischemia.

摘要

目的

研究特发性炎性肌病（IIM）患者血清心肌肌钙蛋白 T（cTnT）和心肌肌钙蛋白 I（cTnI）与肌酸激酶（CK）的相关性。

方法

我们对 2004 年至 2008 年在县医院风湿科就诊的 IIM 患者进行了回顾性研究。排除了心肌缺血和/或肾功能衰竭的患者。记录了临床数据，包括肌电图、肌肉活检以及 CK、cTnT 和 cTnI。研究了同时分析 CK 和心肌肌钙蛋白（cTnT 或 cTnI）水平的患者。采用卡方检验和 Spearman 相关分析比较 CK 水平与 cTnT 和 cTnI 的相关性。

结果

我们确定了符合纳入标准的 49 例 IIM 患者（69 例观察）。主要诊断为多发性肌炎 23 例，皮肌炎 16 例，结缔组织病相关肌炎 10 例。33/49 例女性患者平均年龄 45.8 岁。28 例 IIM 患者同时测定 CK 和 cTnT 值。其中，18/23 例 CK 升高的患者 cTnT 也升高，5/5 例 CK 正常的患者 cTnT 正常（p = 0.005）。在 41 例同时测定 CK 和 cTnI 值的 IIM 患者中，仅 1/29 例 CK 升高的患者 cTnI 升高，12/12 例 CK 正常的患者 cTnI 正常（p = 0.5）。CK 与 cTnT 呈强相关（r = 0.62，p = 0.001），但与 cTnI 不相关。