目的：研究肌钙蛋白对于免疫介导的坏死性肌病（IMNM）合并心脏损伤患者的意义。方法：收集 2015 年 9 月至 2019 年 12 月我科收治的确诊为 IMNM 患者，收集入院首次血清学结果：心肌肌钙蛋白 T （cTnT）、心肌肌钙蛋白（I cTnI）、肌酸激酶（CK），完善肌病临床疾病活动度相关评分：HAQ、MMT-8及MYOACT；完善心电图、心脏彩超、心脏核磁共振并根据检查结果将患者分为心脏正常组和心脏异常组。比较2 组的临床资料，并分析cTnT、cTnI与心脏受损、疾病活动度的关联。结果：总共入组患者39例，纳入心脏正 常组25例，心脏异常组11例；心脏异常组血清cTnI值高于心脏正常组（P=0.043），其他指标间差异无统计学 意义（P＞0.05）。cTnI 与心脏影像学异常显著相关（P＜0.001）；cTnT 与 CK、MMT-8、HAQ 显著相关（P＜ 0.001, P=0.010, P=0.036）；CK与MMT-8评分、HAQ评分有相关性（P=0.042, P=0.053）。结论：心肌肌钙蛋白 是检测IMNM患者心脏受累的潜在筛选工具，cTnI对于评估心脏受损具有价值，而cTnT在评估坏死性肌病 的疾病活动度方面具有价值。

This study is to investigate the significance of serum cardiac troponin for cardiac involvement in patients with immune-mediated necrotizing myopathy (IMNM). Methods: From September 2015 to December 2019, confirmed patients with IMNM admitted to Tongji Hospital were collected. The first serological results of the patients upon admission were obtained, including: cardiac troponin T (cTnT), cTnI, creatine kinase (CK), and the scores related to the activity of clinical myopathy, including Health Assessment Questionnaire (HAQ), manual music testing-8 (MMT-8), and myositis release activity assessment visual analog scale (MYOCT) scores. ECG, echocardiography, and cardiac magnetic resonance were used to distinguish patients with cardiac abnormalities from those without. The clinical data of the abnormal cardiac function group and normal cardiac function group were compared, and the relationship between cTnT and cTnI and cardiac involvement and disease severity was analyzed. Results: A total of 39 patients were enrolled into the study, with 25 patients in the normal group and 11 in the abnormal group. Serum cTnI in the abnormal group was significantly higher than that in the normal group (P=0.043). There was no significant difference in other serological indices (P>0.05). cTnI was significantly correlated with abnormal cardiac imaging (P<0.001); cTnT was significantly correlated with serum CK, MMT-8, and HAQ scores (P<0.001, P=0.010, P=0.036); serum CK was correlated with MMT-8 and HAQ scores (P=0.042, P=0.053). Conclusion: Serum cardiac troponins may have a role in screening for cardiac involvement in IMNM. cTnI may be valuable in assessing the severity of cardiac damage, while cTnT may be useful in determining the activity of immune-mediated necrotizing myopathy.