Dept, of Medicine, Akershus University Hospital and Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, Oslo, Norway.
BMC Pulm Med. 2012 Jul 6;12:22. doi: 10.1186/1471-2466-12-22.
A high-sensitivity cardiac troponin T (hs-cTnT) concentration above the 99th percentile (i.e. 14 ng/L) is common during Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and associated with increased mortality. The objective of the study was to identify factors associated with hs-cTnT levels during AECOPD.
We included 99 patients with AECOPD on admission. As 41 patients had one or more repeat admissions, there were 202 observations in the final analysis. We recorded clinical and biochemical data, medication, spirometry, chest radiographs, and ECGs. The data were analysed for cross-sectional and longitudinal associations using ordinary least square as well as linear mixed models with the natural logarithm of hs-cTnT as the dependent variable.
Mean age at inclusion was 71.5 years, mean FEV1/FVC was 45%, and median hs-cTnT was 27.0 ng/L. In a multivariable model there was a 24% increase in hs-cTnT per 10 years increase in age (p < 0.0001), a 6% increase per 10 μmol/L increase in creatinine (p = 0.037), and a 2% increase per month after enrollment (p = 0.046). Similarly, the ratios of hs-cTnT between patients with and without tachycardia (heart rate ≥100/min) and with and without history of arterial hypertension were 1.25 (p = 0.042) and 1.44 (p = 0.034), respectively. We found no significant association between arterial hypoxemia and elevated hs-cTnT.
Age, arterial hypertension, tachycardia, and serum creatinine are independently associated with the level of hs-cTnT on admission for AECOPD.
在慢性阻塞性肺疾病急性加重（AECOPD）期间，高敏心肌肌钙蛋白 T（hs-cTnT）浓度超过第 99 百分位数（即 14ng/L）很常见，并且与死亡率增加相关。本研究的目的是确定与 AECOPD 期间 hs-cTnT 水平相关的因素。
我们纳入了 99 名入院时患有 AECOPD 的患者。由于 41 名患者有一次或多次重复入院，因此最终分析中有 202 次观察。我们记录了临床和生化数据、药物、肺量测定、胸部 X 光片和心电图。使用普通最小二乘法以及线性混合模型，将 hs-cTnT 的自然对数作为因变量，对横断面和纵向关联进行了分析。
纳入时的平均年龄为 71.5 岁，平均 FEV1/FVC 为 45%，中位 hs-cTnT 为 27.0ng/L。在多变量模型中，hs-cTnT 随年龄每增加 10 岁增加 24%（p<0.0001），随肌酐增加 10μmol/L 增加 6%（p=0.037），在登记后每增加 1 个月增加 2%（p=0.046）。同样，hs-cTnT 在有或无心动过速（心率≥100/min）和有或无高血压病史的患者之间的比值分别为 1.25（p=0.042）和 1.44（p=0.034）。我们没有发现动脉低氧血症与 hs-cTnT 升高之间存在显著关联。
年龄、高血压、心动过速和血清肌酐与 AECOPD 入院时的 hs-cTnT 水平独立相关。
