无典型症状冠心病心肌缺血患者血清Hs-CRP、BNP、GGT及动态心电图特征与意义分析  

Characteristics and significance analysis of serum Hs-CRP,BNP,GGT and dynamic ETC in patients without typical symptoms

作　　者：郭兴 刘宝 GUO Xing;LIU Bao(Department of Cardiology,the First Outpatient Department of Henan Province Administration,Zhengzhou 450000,China;Department of Hypertension,the First Outpatient Department of Henan Province Administration,Zhengzhou 450000,China)

机构地区：[1]河南省直属机关第一门诊部心内科,郑州450000 [2]河南省直属机关第一门诊部高血压科,郑州450000

出　　处：《医药论坛杂志》2023年第14期31-35,共5页Journal of Medical Forum

摘　　要：目的探究无典型症状冠心病心肌缺血患者血清超敏C-反应蛋白(Hs-CRP)、脑利钠肽(BNP)、γ-谷氨酰转肽酶(GGT)以及动态心电图特征与意义。方法选取2020年4月至2022年4月河南省直属机关第一门诊部收治的161例无典型症状的疑似冠心病心肌缺血患者作为研究对象,对患者进行冠状动脉造影检查,并根据患者的检查结果对患者进行分组:研究组纳入经冠状动脉造影检查阳性患者98例,对照组纳入经冠状动脉检查阴性患者63例,所有研究对象均接受动态心电图检查,比较两组患者间的血清Hs-CRP、BNP、GGT水平,分析两组的动态心电图特征差异,探究影响患者发生无典型症状冠心病心肌缺血的影响因素,并采用ROC曲线探究血清Hs-CRP、BNP、GGT及动态心电图特征对无典型症状冠心病心肌缺血的诊断价值。结果与对照组患者相比较,研究组患者的血清BNP、Hs-CRP、GGT水平升高(P<0.05)。研究组患者心肌缺血持续时间长于对照组(P<0.05),但两组间ST段压低发作时间分布比较无统计学差异(P>0.05)。收集两组患者的资料,可知在年龄、性别、收缩压、心率、是否吸烟、高血压、高血脂、空腹血糖、病变血管及Gensini积分方面两组无差异(P>0.05),在舒张压、糖尿病史、尿酸、ST段下移距离方面比较存在差异(P<0.05)。对上述结果中存在差异的因素进行多因素logistic回归分析,以患者是否为冠状动脉造影阳性为因变量,以患者血清BNP、hs-CRP、GGT水平,发作持续时间,舒张压,糖尿病,尿酸,ST段下移距离为自变量,进行分析可知血清BNP、hs-CRP、GGT水平对患者发生无典型症状冠心病心肌缺血存在影响(P<0.05)。血清BNP、hs-CRP、GGT水平,发作持续时间诊断无典型症状冠心病心肌缺血的AUC值分别为0.937、0.889、0.853、0.679(P<0.05)。结论在无症状冠心病心肌缺血患者中,血清Hs-CRP、BNP、GGT水平升高,心肌缺血持续时间更长,且�Objective To explore the characteristics and significance of serum hypersensitive C-reactive protein(Hs-CRP),brain natriuretic peptide(BNP),γ-glutamyl transpeptidase(GGT)and dynamic electrocardiogram in patients without typical symptomatic myocardial ischemia.Methods Totally 161 patients admitted to our hospital from April 2020 to April 2022 were selected as the study subjects,The patient was examined by coronary angiography,Patients were grouped according to their examination results:98 patients were considered positive by the coronary angiography,In the control group,63 patients with negative coronary artery examination were included,All study subjects underwent a Holter ECG,Comparing the serum Hs-CRP,BNP,and GGT levels between the two patient groups,Analyzed the differences in Holter characteristics between the two groups,To explore the factors affecting myocardial ischemia in coronary heart disease without typical symptoms,ROC curve was used to explore the diagnostic value of serum Hs-CRP,BNP,GGT and Holter ECG characteristics on myocardial ischemia without typical symptoms.Results Compared with the control patients,serum BNP,Hs-CRPand Hs-CRP levels were increased in the study group(P<0.05).The duration of myocardial ischemia in the study group was longer than that in the control group(P<0.05),but there was no statistical difference in the distribution of ST depression episodes between the two groups(P>0.05).After collecting the data of the two groups,there were no differences in age,sex,systolic blood pressure,heart rate,smoking blood pressure,hypertension,hyperlipidemia,fasting blood glucose,and diseased blood vessels(P>0.05),and no differences in diastolic blood pressure,diabetes history,uric acid,ST downward shift distance and Gensini score(P<0.05).Multivariate logistics regression analysis was conducted on the different factors in the above results,including whether the patients experienced myocardial ischemia without typical coronary heart disease as the dependent variable,and the serum BNP,hs-CRP,GGT

关 键 词：无典型症状冠心病 心肌缺血 超敏C-反应蛋白 脑利钠肽 Γ-谷氨酰转肽酶 动态心电图 

分 类 号：R541[医药卫生—心血管疾病]