血清CD40配体联合QTc间期水平对冠心病术后心律失常的诊断价值  

Diagnostic value of serum CD40 ligand and QTc interphase level in postoperative arrhythmia of coronary heart disease

作　　者：张倩 李小龙 金梦雪 ZHANG Qian;LI Xiaolong;JIN Mengxue(Department of Functional Examination,Suzhou Hospital of Integrated Chinese and Western Medicine,Jiangsu Province,Suzhou 215000,China;Department of Internal Medicine,Wuzhong District Mudu Town Community Health Service Center,Jiangsu Province,Suzhou 215000,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215000 [2]江苏省苏州市吴中区木渎镇社区卫生服务中心内科,江苏苏州215000

出　　处：《中国医药导报》2023年第35期88-91,共4页China Medical Herald

基　　金：江苏省科技计划项目(BK20191354)。

摘　　要：目的 探究血清CD40配体(CD40L)联合动态心电图QTc间期对冠心病术后心律失常的诊断价值。方法 选取江苏省苏州市中西医结合医院2020年1月至2022年1月收治的冠心病患者89例,收集并整理患者的临床病历资料。对入院后患者进行动态心电图及CD40L水平检测,根据患者经皮冠脉介入术后1个月内是否发生心律失常将其分为发生组(10例)和未发生组(79例)。采用logistic回归模型分析冠心病术后心律失常的影响因素,并进一步通过受试者操作特征(ROC)曲线评估QTc间期及血清CD40L水平对心律失常的诊断价值。结果 发生组血钾、QTc间期、血清CD40L水平均高于未发生组,差异有统计学意义(P<0.05)。影响因素分析结果显示,血钾(OR=3.684,95%CI:1.259~5.685)、QTc间期(OR=2.743,95%CI:1.259~6.666)及血清CD40L(OR=3.340,95%CI:1.374~8.118)均为冠心病患者术后发生心律失常的影响因素(P<0.05)。ROC曲线分析显示,动态心电图QTc间期及血清CD40L水平联合对心律失常的诊断效能高于二者单独预测(P<0.05)。结论 冠心病术后心律失常患者动态心电图及血清CD40L表达水平异常,且血清CD40L联合QTc间期水平对冠心病术后心律失常的诊断价值较高。Objective To explore the diagnostic value of serum CD40 ligand(CD40L)combined with QTc interphase level of ambulatory electrocar-diogram in postoperative arrhythmia of coronary heart disease.Methods A total of 89 patients with coronary heart disease admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to January 2022 were selected.Clinical medical records of the patients were collected and collated,and ambulatory electrocar-diogram and CD40L levels were detected after admission.According to the occurrence of arrhythmia within one month after percutaneous coronary intervention,the patients were divided into occurrence group(ten cases)and non-occurrence group(79 cases).Logistic regression model was used to analyze the influencing factors of postoperative arrhythmia,and the diagnostic value of QTc interphase level and serum CD40L level in arrhythmia was further evaluated by receiver operating characteristics(ROC)curve.Results The levels of serum potassium,QTc interphase level,and CD40L in the occurrence group were higher than those in the non-occurrence group,the differences were statistically significant(P<0.05).Analysis of influencing factors showed that blood potassium(OR=3.684,95%CI:1.259-5.685),QTc interval(OR=2.743,95%CI:1.259-6.666),and serum CD40L(OR=3.340,95%CI:1.374-8.118)were the influential factors for postoperative arrhythmia in patients with coronary heart disease(P<0.05).ROC curve analysis showed that the combined QTc interphase level of ambulatory electrocar-diogram,and serum CD40L level were more effective in diagnosing arrhythmias than those predicted by them alone(P<0.05).Conclusion The QTc interphase level of ambulatory electrocar-diogram and serum CD40L are abnormal in patients with post-coronary heart disease arrhythmia,and the levels of serum CD40L combined with QTc interphase level are of high diagnostic value for postoperative arrhythmia of coronary heart disease.

关 键 词：心律失常 动态心电图 血清CD40配体 冠心病 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]