不同静息心率和心肌坏死标志物与冠心病患者关系的探讨  

Study on the relationship between different resting heart rate and myocardial necrosis markers in patients with coronary heart disease

作　　者：汪玉君[1] 宋巧凤[1] 王希柱[1] WANG Yu-jun;SONG Qiao-feng;WANG Xi-zhu(Department of Cardiology,Tangshan People’s Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市人民医院心内一科,河北唐山063000

出　　处：《中国实验诊断学》2022年第8期1110-1114,共5页Chinese Journal of Laboratory Diagnosis

基　　金：河北省卫生和计划生育委员会科研基金项目(编号:20150978)。

摘　　要：目的 探讨入院不同静息心率和心肌坏死标志物与冠心病患者的关系。方法 随机选取符合纳入标准的冠心病患者186例,根据患者入院时的静息心率分为A、B、C 3组,A组患者的心率为50-70次/min,B组患者的心率为70-90次/min和C组患者的心率超过90次/min,比较3组患者的心率与患者24小时心肌缺血、胸闷发作次数以及心功能的关系,并比较急性心肌梗死(acute myocardial infarction,AMI)和急性心绞痛(Acute angina pectoris,AP)患者心肌坏死标志物表达水平。结果 (1)心肌缺血和胸闷不适的发作次数随着心率上升而显著增加,C组患者的心肌缺血和胸闷不适发作次数显著高于A组以及B组,差异均有统计学意义(P<0.05);(2)随着患者心率上升,左心室舒张末期内径(left ventricular ejection fraction,LVEDD)持续升高且左心射血分数(left ventricular ejection fraction,LVEF)持续下降,C组患者LVEF显著低于A组以及B组(P<0.05);(3)AMI患者的超敏肌钙蛋白(High-sensitivity cardiac troponin,Hs-cTnT)、肌钙蛋白Ⅰ(cardiac troponincTnI)、肌钙蛋白(cardiac troponin,cTnT)、肌红蛋白(Myoglobin,Mb)以及心肌型肌酸激酶同工酶(MB isoenzyme of creatine kinase,CK-MB)水平均显著高于AP患者(P<0.05);(4)C组患者恶性心律失常、心源性猝死、心绞痛、心力衰竭、再梗死等不良事件的发生率显著高于A组和B组,差异有统计学意义(P<0.05)。结论 AMI患者心肌坏死标志物水平高于AP患者,并且入院静息心率>90次/min的患者,其心血管不良事件发生率较高,需注意病情变化,引起临床重视。Objective To investigate the relationship between resting heart rate and myocardial necrosis markers in patients with coronary heart disease.Methods conforms to the inclusion criteria were randomly selected 186cases of patients with coronary heart disease,according to the resting heart rate of patients in hospital were divided into group A(50-70times/min)and group B(70-90times/min)and group C(heart rate over 90times/min),the comparison of three groups of patients with 24hours of myocardial ischemia in patients with heart rate,attack frequency of chest tightness,and the relationship between the cardiac function,and compare the acute myocardial infarction(acute myocardial infarction,AMI)and acute angina(acute angina pectoris.AP)Expression levels of myocardial necrosis markers in patients.Results(1)The incidence of myocardial ischemia and chest discomfort increased significantly with the increase of heart rate.The incidence of myocardial ischemia and chest discomfort in group C was significantly higher than that in group A and B,(P<0.05).(2)As patients’ heart rate rose,the left ventricular ejection fraction(LVEDD)continued to rise and the left ventricular ejection fraction(LVEF)continued to decline.Patients in group C had A significantly lower LVEF than those in group A and B(P<0.05).(3)AMI patients with allergic troponin(High-sensitivity cardiac troponin,HscTnT),troponinⅠ(cardiac troponincTnI),troponin(cardiac troponin,cTnT),Myoglobin(Myoglobin,Mb)and myocardium creatine kinase isoenzyme(Mb isoenzyme of creatine kinase,The levels of CK-MB were significantly higher than those of AP patients(P<0.05).(4)The incidence of adverse events such as heart failure,malignant arrhythmia,angina,re-infarction and sudden cardiac death in group C was significantly higher than that in group A and B(P<0.05).Conclusion patients with AMI have a higher level of myocardial necrosis markers than those with AP and a faster resting heart rate(>90times/min)on admission,with a higher incidence of cardiovascular adverse events.Therefore,it

关 键 词：心率 心肌坏死标志物 冠心病 心绞痛 心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]