血液透析患者の心筋トロポニンTの臨床的意義
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概要
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We examined clinical significance of cardiac troponin T in hemodialysis (HD) patients. We performed echocardiogram and examined all echocardiographic measurements according to the recommendations of the American Society of Echocardiography. Left ventricular function and left ventricular mass index (LVMI) were calculated and brachial ankle Pulse Wave Velocity (ba PWV) and Ankle Brachial Pressure Index (ABI) were also measured using a non-invasive automatic device form PWV/ABI (Nihon Colin Co., AT company, Tokyo, Japan) in 90 patients (45 HD patients, 45 non HD patients). We performed common carotid artery (CCA) ultrasonography and the intimal-medial thickness (IMT) of the CCA was measured. The correlations among physical and laboratory findings, and complications were analyzed.Cardiac TnT was significantly greater in HD group than in non HD group (p<0.0001), and was also significantly greater in the ischemic heart disease (IHD) group than in non IHD group. In HD patients, cTnT correlated positively with LVMI, LVDd and LVEDV. The more left ventricle was hypertrophic, especially eccentric hypertrophy, the greater cTnT increased in HD patients. Cardiac TnT was significantly greater in HD patients when left ventricular systolic function was decreased. In HD patients, cTnT correlated positively with ba PWV and IMT, and negatively with ABI.In conclusion, the degree of atherosclerosis may be severe in HD patients, and cardiac overload, minimal ischemic lesions and myocardial injury may lead to the release of small amounts of cTnT. In HD patients, the serum level of cTnT may indicate the severity of myocardial damage.
- 社団法人 日本透析医学会の論文
- 2003-04-28
著者
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矢野 新太郎
前橋広瀬川クリニック
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渡辺 幸康
渡辺内科クリニック
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清水 幸博
赤城クリニック
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小野 久米夫
上毛大橋クリニック
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小野 久米夫
関越中央病院
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小野 久米夫
渡辺内科クリニック
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矢野 新太郎
上毛大橋クリニック
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