Department of Cardiology, Division of Medicine, Akershus University Hospital, Sykehusveien 27, Lørenskog 1478, Norway.
Heart. 2013 Mar;99(6):382-7. doi: 10.1136/heartjnl-2012-303429. Epub 2013 Jan 12.
To assess the distribution of high-sensitivity cardiac troponin T (hs-cTnT) concentrations in stable chronic obstructive pulmonary disease (COPD), and whether hs-cTnT is associated with pulmonary function.
Prospectively designed, cross-sectional study.
Outpatient clinic of Norwegian teaching hospital and community-based setting.
Sample of 101 stable COPD patients from the hospital's outpatient clinic and 120 individuals derived from a random general population sample.
Ratio of hs-cTnT in stable COPD patients compared with references from the general population. Change in ratio of hs-cTnT per unit increase of relevant covariables.
The crude geometric means of circulating hs-cTnT in the cases and the references were 7.75 and 3.01 ng/l, respectively (p < 0.001); that is, a relative ratio of 2.57 (95% CI 2.05 to 3.23). After adjustment for relevant confounders, this ratio was moderately attenuated to 1.65 (1.31-2.08). In the total study cohort, as well as among stable COPD patients, we found a significant positive association between hs-cTnT and interleukin-6 concentrations (p < 0.001) and the presence of pathologic Q waves (p = 0.023). Among stable COPD patients, one quartile increase in forced expiratory volume 1 was associated with a 39% decrease in hs-cTnT and patient category (Global Initiative of Obstructive Lung Disease classification 2011) was positively associated with hs-cTnT (p trend < 0.001) after multivariate adjustment.
Stable COPD is independently associated with higher hs-cTnT compared with randomly drawn subjects from the general population. In patients with stable COPD, higher hs-cTnT seems to be associated with immune activation and the severity of the disease.
评估稳定期慢性阻塞性肺疾病(COPD)患者高敏心肌肌钙蛋白 T(hs-cTnT)浓度的分布情况,以及 hs-cTnT 是否与肺功能相关。
前瞻性设计,横断面研究。
挪威教学医院的门诊和社区为基础的环境。
来自医院门诊的 101 例稳定期 COPD 患者样本和来自随机一般人群样本的 120 例个体。
与一般人群参考值相比,稳定期 COPD 患者的 hs-cTnT 比值。hs-cTnT 比值随相关协变量单位增加的变化。
病例组和对照组的循环 hs-cTnT 粗几何均值分别为 7.75 和 3.01ng/L(p<0.001);也就是说,相对比值为 2.57(95%CI 2.05-3.23)。调整相关混杂因素后,该比值适度减弱至 1.65(1.31-2.08)。在整个研究队列中,以及在稳定期 COPD 患者中,我们发现 hs-cTnT 与白细胞介素-6 浓度之间存在显著正相关(p<0.001),并且与病理性 Q 波的存在相关(p=0.023)。在稳定期 COPD 患者中,用力呼气量 1 的一个四分位距增加与 hs-cTnT 降低 39%相关,且患者类别(2011 年全球阻塞性肺病倡议分类)与 hs-cTnT 呈正相关(p 趋势<0.001),经过多变量调整后。
稳定期 COPD 与从一般人群中随机抽取的受试者相比,hs-cTnT 水平较高。在稳定期 COPD 患者中,较高的 hs-cTnT 似乎与免疫激活和疾病严重程度相关。