基于12导联动态心电图的ST段联合卵磷脂胆固醇脂酰基转移酶、 脂蛋白a对冠心病的诊断价值  

Diagnostic value of ST segment based on 12-lead dynamic electrocardiogram combined with lecithin cholesterol acyltransferase and lipoprotein a in the diagnosis of coronary heart disease

作　　者：蔡宏华 张美玲 骆小娟 CAI Honghua;ZHANG Meiling;LUO Xiaojuan(Department of Electrocardiography,Affiliated Hospital of Guangdong Medical University,Guangdong,Zhanjiang 524001,China;Department of Laboratory Medicine,No.4 People's Hospital of Zhanjiang,Guangdong,Zhanjiang 524000,China)

机构地区：[1]广东医科大学附属医院心电图室,广东湛江524001 [2]广东省湛江市第四人民医院检验科,广东湛江524000

出　　处：《中国医药科学》2021年第15期180-182,196,共4页China Medicine And Pharmacy

基　　金：广东省湛江市科技攻关计划项目(2020B01269)。

摘　　要：目的探讨12导联动态心电图的ST段联合血清卵磷脂胆固醇脂酰基转移酶、脂蛋白a检测对冠心病患者的诊断价值。方法选取2020年4月至2020年12月广东医科大学附属医院收治的120例冠心病患者进行研究,根据冠状动脉造影结果分为CAG阳性组(n=66)和CAG阴性组(n=54)。检测并比较两组患者的血清磷脂胆固醇酰基转移酶(LCAT)、脂蛋白a(LPa)水平及心肌缺血ST段压低发作时间。比较单独及联合检测的诊断效能。以冠状动脉造影术(CAG)结果作为诊断金标准。结果CAG阳性组患者的血清LPa、LCAT水平高于CAG阴性组,差异有统计学意义(P<0.05);两组各个时间段的心肌缺血ST段压低发作时间比较,差异无统计学意义(P>0.05);三者联合检测的特异度、准确度高于单独检测。结论12导联动态心电图的ST段联合血清LPa、LCAT检测可有效提高对冠心病的诊断准确率。Objective To investigate the diagnostic value of ST segment based on 12-lead dynamic electrocardiogram(ECG)combined with serum lecithin cholesterol acyltransferase and lipoprotein a in patients with coronary heart disease.Methods A total of 120 patients with coronary heart disease admitted to the Affiliated Hospital of Guangdong Medical University from April 2020 to December 2020 were selected for the study,and were divided into the CAG-positive group(n=66)and the CAG-negative group(n=54)according to the coronary angiography(CAG)results.The serum levels of lecithin cholesterol acyltransferase(LCAT),lipoprotein a(LPa)and the time to onset of ST-segment depression due to myocardial ischemia were measured and compared between the two groups.The diagnostic efficacy of the three tests alone and in combination was compared.The CAG results were used as the gold standard of diagnosis.Results Serum LPa and LCAT levels in the CAGpositive group were higher than those in the CAG-negative group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the time to onset of ST-segment depression due to myocardial ischemia in each time period between the two groups(P>0.05).The specificity and accuracy of the combined test of the three were higher than those of the individual test.Conclusion The ST segment based on 12-lead dynamic ECG combined with serum LPa and LCAT testing can effectively improve the diagnostic accuracy of coronary heart disease.

关 键 词：12导联动态心电图 卵磷脂胆固醇脂酰基转移酶 脂蛋白A 冠心病 诊断效能 

分 类 号：R541.4[医药卫生—心血管疾病]