冠心病患者心肌复极异常心电图表现与cTnI及CK-MB的关系  

The Relationship Between Abnormal Repolarization ECG and cTnI and CK-MB with Coronary Heart Disease

作　　者：陈瑜 廖虹[1] 李燕丽[1] 梁玲娣[1] 孙静[1] 廖建柳 宋筱海 CHEN Yu;LIAO Hong;LI Yanli;LIANG Lingdi;SUN Jing;LIAO Jianliu;SONG Xiaohai(Functional Section of Guangxi Liuzhou People’s Hospital,Liuzhou 545000, China)

机构地区：[1]广西柳州市人民医院功能科,广西柳州545000

出　　处：《标记免疫分析与临床》2021年第12期2152-2156,共5页Labeled Immunoassays and Clinical Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z20180276)。

摘　　要：目的探讨冠心病心肌复极异常心电图表现与肌钙蛋白I(cardiac troponin I,cTnI)及磷酸肌酸激酶心型同工酶(creatine kinase,CK-MB)的关系。方法选择2018年2月至2020年2月于我院就诊的冠心病患者120例,并根据临床表现,将患者分为3组:稳定型心绞痛组(stable angina pectoris,SAP)、不稳定型心绞痛组(unstable angina pectoris,UAP)、急性心肌梗死组(acute myocardial infarction,AMI),每组40例。此外选择40例健康的体检者作为对照组。收集患者临床资料,检测心肌酶谱和生化指标,分析心电图特征与cTnI及CK-MB的关系。结果SAP、UAP、AMI组总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL-C)明显大于对照组,高密度脂蛋白(high density lipoprotein,HDL-C)明显小于对照组(P<0.05),AMI组TC、TG、LDL-C明显大于UAP、SAP组,HDL-C明显小于对照组(P<0.05)。4组受试者V_(2)导联Tp-Te间期差异具有统计学意义(P<0.05),SAP、UAP、AMI组患者T波异常、ST段异常的发生率明显大于对照组(P<0.05)。AMI、UAP组cTnI、CK-MB、CK、谷草转氨酶(glutamic oxaloacetic transaminase,AST)明显高于对照组与SAP组(P<0.05),AMI组cTnI、CK-MB、CK、AST水平均明显高于UAP组(P<0.05)。ST段异常、T波异常组患者cTnI、CK-MB明显高于ST段正常、T波正常组患者(P<0.05)。结论冠心病患者血清cTnI及CK-MB表达增加,且cTnI及CK-MB与心电图复极异常存在一定的关系,可为临床治疗提供一定的参考。Objective To explore the relationship between abnormal ECG manifestations of repolarization and cTnI and CK-MB with coronary heart disease.Methods 120 patients with coronary heart disease were selected from February,2018 to February,2020.According to the type of coronary heart disease,these patients were divided into three groups:stable angina group(SAP),unstable angina group(UAP),and acute myocardial infarction(AMI),with 40 cases in each group.The clinical data of these patients were collected.The levels of myocardial enzyme spectrum and biochemical indexes were measured,and the relationship between ECG characteristics and cTnI and CK-MB was analyzed.Results TC,TG and LDL-C in the SAP,UAP and AMI group were significantly higher than those in the control group,while HDL-C was significantly lower than those in the control group(P<0.05).TC,TG and LDL-C in the AMI group were significantly higher than those in the UAP and SAP groups,while HDL-C was significantly lower than those in the control group(P<0.05).There was a significant difference in TP-Te interval of V2 lead among the four groups(P<0.05).The incidence of T wave abnormality and ST segment abnormality in the SAP,UAP and AMI groups was significantly higher than that of the control group(P<0.05).CTnI,CK-MB,CK,and AST in the AMI group and UAP group were significantly higher than those in the control group and SAP group(P<0.05),and cTnI,CK-MB,CK,AST in the AMI group were significantly higher than those in the UAP group(P<0.05).CTnI and CK-MB were significantly higher in patients with abnormal ST segment and T wave than those in patients with normal ST segment and T wave(P<0.05).Conclusion The expressions of cTnI and CK-MB are increased in patients with coronary heart disease,and there is a correlation between cTnI and CK-MB and abnormal repolarization of ECG,which could provide some references for the clinical treatment.

关 键 词：冠心病 心肌复极异常 心电图 CTNI CK-MB 

分 类 号：R446.6[医药卫生—诊断学]