心电图QRS波时限联合血清铁蛋白检测对T2DM合并冠心病患者心功能不全的诊断价值  

Diagnostic value of QRS duration of ECG combined serum ferritin detection for cardiac dysfunction in T2DM + CHD patients

作　　者：徐超 肖勇[1] 高妍[1] 李倩[1] 曹玉姣 李立彬[1] XU Chao;XIAO Yong;GAO Yan;LI Qian;CAO Yu-jiao;LI Li-bin(Department of Function,Jizhong Energy Xingtai Mining Group Co.,Ltd.General Hospital,Xingtai,Hebei,054000,China)

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院功能科,河北邢台054000

出　　处：《心血管康复医学杂志》2022年第3期330-334,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察心电图QRS波时限联合血清铁蛋白检测对2型糖尿病(T2DM)合并冠心病(CHD)患者心功能评价的价值。方法:收集2016年3月~2019年2月本院单纯T2DM(T2DM组)79例,同期T2DM合并CHD患者(T2DM+CHD组)79例为研究对象,根据彩超检查结果,T2DM+CHD组又分为心功能不全组(47例)和心功能正常组(32例),检测各组患者QRS波时限、校正QT间期(QTc)、血清铁蛋白水平;分析心电图QRS波时限联合血清铁蛋白检测对T2DM合并CHD患者心功能不全的诊断价值。结果:与T2DM组相比,T2DM+CHD组QRS波时限、QTc和血清铁蛋白水平均显著增加(P均=0.001)。与心功能正常组相比,心功能不全组QRS波时限、QTc和血清铁蛋白水平均显著增加(P均<0.05)。QRS波时限联合血清铁蛋白水平诊断T2DM合并CHD患者心功能不全的灵敏度(80.85%),特异性(96.88%),准确度(87.34%)要高于单独QRS波时限诊断(65.96%,84.38%,73.42%)、单独血清铁蛋白水平诊断(74.47%,71.88%,73.42%);QRS波时限联合血清铁蛋白水平诊断的特异性显著高于单独血清铁蛋白水平诊断(96.88%比71.88%,P=0.005)。结论:2型糖尿病合并冠心病心功能不全者QRS波时限、QTc及血清铁蛋白水平较2型糖尿病合并冠心病患者显著增加,心电图QRS波时限、血清铁蛋白联合检测较单独检测血清铁蛋白对2型糖尿病合并冠心病患者心功能不全的特异性诊断价值显著升高。Objective:To observe the diagnostic value of QRS duration of ECG combined serum ferritin tetection for cardiac function in patients with type 2 diabetes mellitus(T2DM)complicated coronary heart disease(CHD).Methods:From Mar 2016 to Feb 2019,a total of 79 simple T2DM patients(T2DM group),and 79 T2DM+CHD patients(T2DM+CHD group)were simultaneously enrolled.According to color ultrasound results,T2DM+CHD group was further divided into cardiac dysfunction group(n=47)and normal cardiac function group(n=32).QRS duration,corrected QT interval(QTc)and serum ferritin level were measured and compared among above groups;diagnostic value of QRS duration of ECG combined serum ferritin detection for cardiac dysfunction was analyzed in T2DM+CHD patients.Results:Compared with T2DM group,there were significant rise in QRS duration,QTc and serum ferritin level in T2DM+CHD group,P=0.001 all.Compared with normal cardiac function group,there were significant rise in QRS duration,QTc and serum ferritin level in cardiac dysfunction group,P<0.05 all.Sensitivity(80.85%),specificity(96.88%)and accuracy(87.34%)of QRS duration combined serum ferritin level in diagnosing cardiac dysfunction in T2DM+CHD patients were higher than those of single QRS duration(65.96%,84.38%,73.42%)and single serum ferritin level(74.47%,71.88%,73.42%);specificity of QRS duration combined serum ferritin level was significantly higher than that of single serum ferritin level(96.88%vs.71.88%,P=0.005).Conclusion:Compared with T2DM+CHD patients,the QRS duration,QTc and serum ferritin level significantly rise in T2DM+CHD patients with cardiac dysfunction.QRS duration combined serum ferritin level possess higher diagnostic value than single detection serum ferritin level for specificity in diagnosing cardiac dysfunction of these patients.

关 键 词：冠心病 糖尿病 2型 心电描记术 

分 类 号：R541.4[医药卫生—心血管疾病]