冠心病心肌缺血后心电图波形变化规律与炎性因子表达关系  

Relationship between changes of electrocardiogram waveform and expression of inflammatory factors after myocardial ischemia in coronary heart disease

作　　者：崔海玲[1] 林虹 CUI Hailing;LIN Hong(Department of Function,Yan’an People’s Hospital,Yan’an 716000,China)

机构地区：[1]延安市人民医院功能科,陕西延安716000 [2]商洛职业技术学院附属医院心电图室,陕西商洛726000

出　　处：《陕西医学杂志》2022年第4期445-448,453,共5页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2021SF-312)。

摘　　要：目的:探讨与分析冠心病心肌缺血后心电图波形变化规律与炎性因子表达的关系。方法:选择冠心病心肌缺血患者88例与冠心病非心肌缺血患者88例作为心肌缺血组与非心肌缺血组,所有患者都给予心电图、超声心功能检查,检测血清炎性因子表达水平并进行相关性分析。结果:两组的心电图RR间期、T波时限、PR间期比较差异无统计学意义(均P>0.05),心肌缺血组的QRS时限低于非心肌缺血组(P<0.05)。心肌缺血组的血清C-反应蛋白(CRP)与白介素(IL)-6含量高于非心肌缺血组(P<0.05)。心肌缺血组的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)高于非心肌缺血组(均P<0.05),左室射血分数(LVEF)低于非心肌缺血组(P<0.05)。在心肌缺血组中,Pearson分析显示QRS时限与LVEF存在正相关性(P<0.05),与CRP、IL-6、LVEDD、LVESD、LVESV、LVEDV存在负相关性(均P<0.05)。ROC曲线显示QRS时限诊断冠心病心肌缺血的曲线下面积为0.597,诊断敏感性与特异性分别为65.9%和71.4%。结论:冠心病心肌缺血可伴随有心电图波形变化异常与炎性因子的大量释放,QRS时限与患者的心功能与炎性因子表达存在相关性,诊断冠心病心肌缺血也有很好的价值。Objective:To explore and analysis the relationship between the changes of electrocardiogram waveform and the expression of inflammatory factors after myocardial ischemia in coronary heart disease.Methods:88 cases of patients with coronary heart disease myocardial ischemia were selected as the myocardial ischemia group,and 88 cases of patients with coronary heart disease and non-myocardial ischemia were selected as non-myocardial ischemia group.All patients were given ECG and ultrasonic cardiac function examination,and the expression levels f serum inflammatory factors were detected and the correlation analysis was carried out.Results:There was no significant difference in RR interval,T wave duration and PR interval between the two groups(all P>0.05).The QRS duration of myocardial ischemia group was lower than that of non-myocardial ischemia group(P<0.05).Serum levels of C-reactive protein(CRP)and interleukin(IL)-6 in the myocardial ischemia group were higher than those in the non-myocardial ischemic group(all P<0.05).The left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)in myocardial ischemia group were higher than those in non-myocardial ischemia group,and the left ventricular ejection fraction(LVEF)was lower than that in non-myocardial ischemia group(all P<0.05).In myocardial ischemia group,Pearson analysis showed that QRS duration was positively correlated with LVEF,and negatively correlated with CRP,IL-6,LVEDD,LVESD,LVESV and LVEDV(all P<0.05).ROC curve analysis showed that the area under the curve for QRS duration in diagnosis of coronary heart disease myocardial ischemia was 0.597,and the sensitivity and specificity were 65.9% and 71.4%,respectively.Conclusion:Coronary heart disease myocardial ischemia can be accompanied by abnormal changes in ECG waveform and the release of a large amount of inflammatory factors.QRS duration is correlated with cardiac function and expression

关 键 词：冠心病 心肌缺血 心电图 炎性因子 QRS 心功能 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]