【摘要】 目的 探讨老年高血压合并心力衰竭患者血清心肌损伤标志物肌钙蛋白I(cTNI)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、N末端B型脑钠肽前体(NT-proBNP)水平变化及其临床价值。方法 选取2022年2月至2024年2月该院的老年高血压合并心力衰竭患者110例为高血压合并心力衰竭组，同期选取单纯心力衰竭患者110例为心力衰竭组，单纯高血压患者110例为高血压组。比较各组血清cTNI、MYO、CK-MB、NT-proBNP水平，采用多因素Logistic回归分析高血压合并心力衰竭的影响因素，绘制受试者工作特征(ROC)曲线分析血清cTNI、MYO、CK-MB、NT-proBNP对高血压合并心力衰竭的诊断效能。结果 与高血压组比较，高血压合并心力衰竭组、心力衰竭组血清cTNI、MYO、CK-MB、NT-proBNP水平升高(P<0.05);与心力衰竭组比较，高血压合并心力衰竭组血清MYO、NT-proBNP水平升高(P<0.05)。多因素Logistic回归分析结果显示，NT-proBNP是高血压合并心力衰竭的独立影响因素(P<0.05)。ROC曲线结果显示，血清cTNI、MYO、CK-MB、NT-proBNP单独及联合诊断高血压合并心力衰竭的曲线下面积分别为0.768、0.729、0.687、0.904、0.905,灵敏度分别为96.4%、50.0%、79.1%、90.0%、90.9%,特异度分别为54.1%、100.0%、60.0%、78.2%、75.0%。结论 血清cTNI、MYO、CK-MB、NT-proBNP在老年高血压合并心力衰竭患者中呈高表达，四者联合对高血压合并心力衰竭具有较高的诊断价值。更多还原

【Abstract】 Objective To explore the changes in the levels of serum myocardial injury markers troponin I(cTNI),myoglobin(MYO),creatine kinase isoenzyme(CK-MB),and N-terminal pro-B natriuretic peptide precursor(NT-proBNP) in elderly patients with hypertension complicated with heart failure and their clinical value.Methods A total of 110 elderly patients with hypertension complicated with heart failure in the hospital from February 2022 to February 2024 were selected as the hypertension complicated with heart failure group.During the same period, 110 patients with simple heart failure were selected as the heart failure group, and 110 patients with simple hypertension were selected as the hypertension group.The levels of serum cTNI,MYO,CK-MB and NT-proBNP in each group were compared.Multivariate Logistic regression was used to analyze the influencing factors of hypertension complicated with heart failure.The receiver operating characteristic(ROC) curve was drawn to analyze the diagnostic efficacy of serum cTNI,MYO,CK-MB and NT-proBNP for hypertension complicated with heart failure.Results Compared with the hypertension group, the levels of serum cTNI,MYO,CK-MB and NT-proBNP in the hypertension combined with heart failure group and the heart failure group increased(P<0.05);Compared with the heart failure group, the levels of serum MYO and NT-proBNP in the hypertension combined with heart failure group increased(P<0.05).The results of multivariate Logistic regression analysis showed that NT-proBNP was an independent influencing factor for hypertension complicated with heart failure(P<0.05).The results of the ROC curve showed that the areas under the curve of serum cTNI,MYO,CK-MB,and NT-proBNP alone and in combination for the diagnosis of hypertension complicated with heart failure were 0.768,0.729,0.687,0.904,and 0.905,respectively.The sensitivities were 96.4%,50.0%,79.1%,90.0% and 90.9% respectively, and the specificities were 54.1%,100.0%,60.0%,78.2% and 75.0% respectively.Conclusion Serum cTNI,MYO,CK-MB and NT-proBNP are highly expressed in elderly patients with hypertension complicated with heart failure.The combination of the four has a high diagnostic value for hypertension complicated with heart failure.更多还原