急性失血性贫血对患者心电图及肌钙蛋白Ⅰ的作用  

Cross-sectional study: the effect of acute hemorrhagic anemia on the electrocardiogram and troponin Ⅰ in patients

作　　者：魏卫霞 刘常远 李运改 刘津毓 迪丽努尔•木沙 魏钧伯[1] 韩蓓蓓[1] 沈成兴 李永光[1] 胡伟国[1] WEI Weixia;LIU Changyuan;LI Yungai;LIU Jinyu;Dilinuer·Musha;WEI Junbo;HAN Beibei;SHEN Chengxing;LI Yongguang;HU Weiguo(Department of Cardiology,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 200233,China;Department of Clinical Laboratory,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 200233,China;Department of General Surgery,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 200233,China;Department of Neurology,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 200233,China;Department of Cardiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201800,China)

机构地区：[1]上海交通大学附属第六人民医院心内科,上海200233 [2]上海交通大学附属第六人民医院检验科,上海200233 [3]上海交通大学附属第六人民医院普外科,上海200233 [4]上海交通大学附属第六人民医院神经内科,上海200233 [5]上海交通大学医学院附属瑞金医院心内科,上海201800

出　　处：《内科理论与实践》2020年第6期381-385,共5页Journal of Internal Medicine Concepts & Practice

基　　金：国家自然科学基金青年基金项目(项目编号:81800331);上海交通大学“医工交叉基金”项目(项目编号:YG2017QN23);上海市卫生健康委员会科研课题(项目编号:201940079)。

摘　　要：目的:通过分析急性失血性贫血对患者心电图12导联变化及心肌损伤的作用,为临床进一步心电图鉴别及干预提供参考。方法:参考贫血标准调阅我院2018年6月—7月的急性失血性贫血住院患者,完成心电图检查者106例(观察组),同期入院无贫血患者完成心电图检查103例(对照组)。比较2组患者肌钙蛋白I水平,同时分析各导联心电图改变情况。结果:观察组肌钙蛋白-I[(0.026 4±0.103 8)μg/L]显著高于对照组[(0.000 6±0.004 0)μg/L,P<0.05]。观察组患者心电图AVF[(-0.009 2±0.242 3) m V)]、V4[(-0.012 7±0.032 2) m V]、V5[(-0.017 0±0.032 1) m V]及V6[(-0.016 8±0.031 6) m V]导联ST段压低值均高于对照组[AVF (-0.000 5±0.005 0)、V4(-0.003 4±0.016 1)、V5(-0.006 4±0.024 0)及V6(-0.007 4±0.024 8) m V,均P<0.01]。急性失血性贫血患者的年龄、红细胞、血小板、血糖、总胆固醇、三酰甘油及心率与肌钙蛋白I的含量之间存在线性相关(均P<0.05)。结论:急性失血性贫血可引起心电图AVF、V4、V5及V6导联ST段压低,同时观察组肌钙蛋白I升高,提示贫血对心电图、心肌损伤标志物可能有影响。Objective To analyze the relationship between acute hemorrhagic anemia and the changes in 12 electrocardiogram (ECG) and the myocardial injury.Methods The medical records of this study were randomly chosen from Shanghai Sixth People’s Hospital.A total of 209 patients who received ECG examination during June 2018 to July 2018 were included in the study.Among them,103 patients with acute hemorrhagic anemia were taken as the observation group,and 106 patients without anemia were taken as the control group.We did retrospective analysis about the demographic characteristics/profiles and compared the ECG changes between the two groups.Results The demographic characteristics:troponin I (Tn-I) of the observation group[(0.026 4±0.103 8)μg/L]was significantly higher than that of the control group[(0.000 6±0.004 0)μg/L,P<0.05].The ST segment changes of each lead in ECG:the ST segment depression values of AVF[(-0.009 2±0242 3) m V)]、V4[(-0.012 7±0.032 2) m V]、V5[(-0.017 0±0.032 1) m V]and V6[(-0.016 8±0.031 6) m V]leads in the observation group were higher than those in the control group[AVF (-0.000 5±0.005 0) m V、V4(-0.003 4±0.016 1)、V5(-0.006 4±0.024 0)、V6(-0.007 4±0.024 8) m V,P<0.01].There were linear corrolations between troponin I and age,erythrocyte and platelet counts,blood glucose,total cholesterol,triglyceride levels as well as heart rate in patients with acute blood loss (P<0.05).Conclusions Acute hemorrhagic anemia is one of the causes leading to AVF,V4,V5and V6ST segment depression I in ECG.At the same time,the elevated troponin I in the observation group suggested that anemia might affect ECG and the markers of myocardial injury.

关 键 词：贫血 心电图 心肌损伤 

分 类 号：R556[医药卫生—血液循环系统疾病] R542.2[医药卫生—内科学]