心电图缺血性J波联合血清尿酸水平对冠心病心力衰竭合并心律失常的诊断价值  

Diagnosis value of ischemic J wave of electrocardiogram combined with serum uric acid level in patients with coronary heart disease heart failure complicated with arrhythmia

作　　者：王晓玲 王晓琴[2] 李爱萍[1] WANG Xiaoling;WANG Xiaoqin;LI Aiping(Electrocardiogram Room,Huaibei People's Hospital,Huaibei Anhui 235000,China;Cardiovascular Medicine Department,Huaibei People's Hospital,Huaibei Anhui 235000,China)

机构地区：[1]淮北市人民医院心电图室,安徽淮北235000 [2]淮北市人民医院心血管内科,安徽淮北235000

出　　处：《新疆医科大学学报》2023年第5期648-652,共5页Journal of Xinjiang Medical University

基　　金：安徽省自然科学基金项目(2108085M32)。

摘　　要：目的探讨心电图缺血性J波联合血清尿酸(Uric acid,UA)水平对冠心病心力衰竭合并心律失常的诊断价值。方法选取淮北市人民医院2021年1月-2022年6月收治的102例冠心病心力衰竭患者(冠心病心力衰竭组),另根据倾向性评分匹配102例健康志愿者(健康组)。观察两组心电图缺血性J波和血清UA水平;比较合并心律失常患者(n=78)和未合并心律失常患者(n=24)的心电图缺血性J波和血清UA水平;分析血清UA、心电图缺血性J波二者单独诊断及血清UA诊断+心电图缺血性J波诊断(联合诊断)对冠心病衰竭合并心律失常的诊断价值。结果冠心病心力衰竭组血清UA水平高于健康组(P<0.05),合并心律失常占比76.47%。与未合并心律失常患者比较,合并心律失常患者年龄和心功能分级高、心力衰竭病程长(P<0.05),肾小球滤过率(Estimated glomerular filtration rate,eGFR)和使用袢利尿剂占比低(P<0.05),心电图缺血性J波占比和血清UA水平高(P<0.05)。血清UA诊断合并心律失常的最佳截断点为410.35μmol/L,灵敏度、特异度、曲线下面积(Area under curve,AUC)分别为79.49%、87.50%、0.807,心电图缺血性J波诊断合并心律失常的灵敏度、特异度分别为76.92%、91.67%,联合诊断的灵敏度、特异度和AUC分别为97.44%、83.33%、0.876。结论冠心病心力衰竭患者心电图缺血性J波占比和血清UA水平高,且联合诊断心律失常的效能高。Objective To explore the ischemic J wave of electrocardiogram combined with serum uric acid(UA)level in diagnosis of coronary heart disease heart failure with arrhythmia.Methods 102 patients with coronary heart disease heart failure treated in Huaibei People's Hospital from January 2021 to June 2022 were enrolled(coronary heart disease heart failure group).In addition,102 healthy volunteers were enrolled according to the propensity score matching(healthy group).The ischemic J-wave and serum UA levels in the electrocardiogram of the patients with concomitant arrhythmia(n=78)and the patients without concomitant arrhythmia(n=24)were compared.The diagnosis value of ischemic J wave of electrocardiogram,serum UA and the combination of the two in coronary heart disease heart failure complicated with arrhythmia was analyzed.Results The level of UA in coronary heart disease heart failure group was higher than that in healthy group(P<0.05).76.47%patients were complicated with arrhythmia.The age and cardiac function grade of the patients with arrhythmia were higher than those without,and the course of heart failure was longer than the latter(P<0.05),and the estimated glomerular filtration rate(eGFR)and the proportion of loop diuretics used were lower than the latter(P<0.05).The ischemic J wave ratio and serum UA level in patients with arrhythmia were higher than those without(P<0.05).The optimal cutoff point for diagnosing combined arrhythmia with serum UA was 410.35μmol/L,sensitivity,specificity,and area under curve(AUC)were 79.49%,87.50%,and 0.807,respectively.The sensitivity and specificity of ischemic J wave electrocardiogram in diagnosing arrhythmia were 76.92%and 91.67%,respectively.The sensitivity,specificity,and AUC of combined diagnosis were 97.44%,83.33%,and 0.876,respectively.Conclusion In patients with coronary heart disease heart failure,the ischemic J wave ratio of electrocardiogram and the level of serum UA are high,and the combined diagnosis of arrhythmia has high efficiency.

关 键 词：心电图 缺血性J波 尿酸 冠心病心力衰竭 心律失常 

分 类 号：R541.4[医药卫生—心血管疾病] R541.7[医药卫生—内科学]