心电图T波变化联合血清同型半胱氨酸对心肌梗死经皮冠脉介入术后患者预后的预测价值  

Prognostic value of electrocardiogram T wave changes combined with ser-um homocysteine in patients with myocardial infarction after percutaneous coronary intervention

作　　者：金梦雪 张倩 JIN Mengxue;ZHANG Qian(Department of Functional Examination,Suzhou Hospital of Integrated of Traditional and Western Medicine,Jiangsu Province,Suzhou 215101,China)

机构地区：[1]江苏省苏州市中西医结合医院功能检查科,江苏苏州215101

出　　处：《中国医药导报》2023年第32期84-87,共4页China Medical Herald

基　　金：江苏省妇幼健康科研项目(F201821)。

摘　　要：目的探究心电图T波变化联合血清同型半胱氨酸(Hcy)对心肌梗死(MI)经皮冠脉介入术(PCI)后患者预后的预测价值。方法选江苏省苏州市中西医结合医院2017年1月至2022年7月收治的MI患者76例,行PCI手术,根据术后1年内不良心血管事件(MACE)的发生情况分为预后良好组和预后不良组。比较两组一般资料、心电图T波变化情况及血清Hcy水平,分析影响PCI术后MI患者预后的因素,并采用受试者操作特征(ROC)曲线分析心电图T波变化联合血清Hcy对PCI术后MI患者预后的评估价值。结果76例行PCI的MI患者术后1年内54例患者未发生MACE,22例患者发生MACE。预后不良组T波倒置人数占比及血清Hcy水平高于预后良好组,差异有统计学意义(P<0.05)。经logistic回归分析,血清Hcy水平、T波倒置是MI患者PCI术后预后不良的独立危险因素(OR>1,P<0.05)。经ROC曲线分析显示,Hcy水平、T波倒置评估MI患者PCI术后预后的AUC值分别为0.773(95%CI:0.662~0.861),0.771(95%CI:0.660~0.860),二者联合预测的AUC值为0.904(95%CI:0.815~0.960)。结论心电图T波变化及血清Hcy水平对于MI PCI术后患者预后均有一定的预测价值,二者联合的预测价值更高。Objective To explore the prognostic value of electrocardiogram T-wave changes combined with serum homocysteine(Hcy)in patients with myocardial infarction(MI)after percutaneous coronary intervention(PCI).Methods A total of 76 MI patients admitted to Suzhou Hospital of Integrated and Western Medicine from January 2017 to July 2022 were selected for PCI.According to the occurrence of major adverse cardiovascular events(MACE)within one year after surgery,they were divided into good prognosis group and poor prognosis group.The general data,electrocardiogram T-wave changes and serum Hcy levels of MI patients in the two groups were compared to analyze the factors affecting the prognosis of MI patients after PCI,and the receiver operating characteristic(ROC)curve was used to analyze the value of electrocardiogram T-wave changes combined with serum Hcy in evaluating the prognosis of MI patients after PCI.Results In 76 MI patients who underwent PCI,a total of 54 patients did not develop MACE and 22 patients developed MACE within one year after surgery.The proportion of T wave inversion and serum Hcy level in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that serum Hcy level and T wave inversion were independent risk factors for poor prognosis of MI patients after PCI(OR>1,P<0.05).ROC curve analysis showed that the AUC value of Hcy level and T-wave inversion in assessing the prognosis of MI patients after PCI was 0.773(95%CI:0.662-0.861)and 0.771(95%CI:0.660-0.860),respectively,and the AUC value predicted by the combination of the two was 0.904(95%CI:0.815-0.960).Conclusion The changes of electrocardiogram T wave and serum Hcy level have certain predictive value for the prognosis of MI patients after PCI,and the combined value is higher.

关 键 词：心电图T波 同型半胱氨酸 心肌梗死 经皮冠脉介入术 预后 

分 类 号：R542.22[医药卫生—心血管疾病]