动态心电图联合血清Lp-PLA2、Cys C诊断冠心病无症状心肌缺血的价值  

Diagnostic Value of 24h Dynamic Electrocardiogram Combined with Serum Lp-PLA2 and Cys C In Asymptomatic Myocardial Ischemia

作　　者：王飞[1] 鲍婷婷[1] 龚梅 高琳琳[1] 阮中宝[1] WANG Fei;BAO Ting-ting;GONG Mei;GAO Ling-ling;RUAN Zhong-bao(Taizhou People’s Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院,江苏泰州225300

出　　处：《泰州职业技术学院学报》2021年第6期64-66,69,共4页Journal of Taizhou Polytechnic College

摘　　要：目的分析24 h动态心电图(DCG)联合血清脂蛋白相关磷脂酶A2(Lp-PLA2)、胱抑素C(Cys-C)对冠心病并发无症状心肌缺血的诊断价值。方法选取2018年1月至2020年12月住院行冠脉造影确诊冠心病的无症状性心肌缺血141例(观察组),同期住院冠脉造影排除冠心病的患者108例作为对照组。比较两组患者DCG检查结果及血清Lp-PLA2、Cys C水平,绘制ROC曲线以评价DCG检查和血清Lp-PLA2、Cys C水平及三者联合对冠心病无症状心肌缺血的诊断价值。结果观察组血清LpPLA2、Cys C水平及心肌缺血发作例数、持续时间、ST段下降幅度均高于对照组(P<0.001);ROC曲线分析结果显示,DCG联合血清Lp-PLA2、Cys C水平检测的诊断效能最大:曲线下面积(AUC)0.893,约登指数0.749,灵敏度92.62%,特异度85.27%,阳性预测值91.69%,阴性预测值87.65%。结论DCG联合血清Lp-PLA2、Cys C水平检测提高了对冠心病无症状心肌缺血患者的诊断准确率,有助于早期诊断。Objective To analyze the diagnostic value of 24 h dynamic electrocardiogram(DCG)combined with serum lipoprotein-related phospholipase A2(Lp-PLA2)and cystatin C(Cys-C)in asymptomatic myocardial ischemia.Methods 141 patients with coronary heart disease(CHD)complicated with asymptomatic myocardial ischemia were continuously collected as observation group.108 patients without CHD were selected as control group.The clinical diagnostic value of DCG and serum Lp-PLA2 and Cys-C was analyzed.Results The levels of serum Lp-PLA2 and Cys-C in observation group were significantly higher than those in control group(P<0.001).The diagnosis of asymptomatic myocardial ischemia in observation group was diagnosed as 120(85.1%)cases,and 28(25.9%)cases were confirmed in the control group(P<0.001).Meanwhile,the ST-segment declined amplitude and ischemia duration were longer than those in control group(P<0.001).ROC curves analysis showed that diagnostic efficiency of DCG combined with serum Lp-PLA2 and Cys-C was the greatest(AUC:0.893,Youden index:0.749,sensitivity:92.62%,specificity:85.27%,positive predictive value:91.69%,negative predictive value:87.65%).Conclusion DCG combined with detection of serum Lp-PLA2 and Cys-C has relatively high diagnostic value on CHD with asymptomatic myocardial ischemia.

关 键 词：动态心电图 脂蛋白相关磷脂酶A2 胱抑素C 冠心病 无症状心肌缺血 

分 类 号：R540.4[医药卫生—心血管疾病]