心电图结合血清肌酸激酶同工酶水平对急性心肌梗死并发室性心律失常的诊断价值  

Diagnostic value of electrocardiogram combined with serum creatine kinase isoenzyme level in acute myocardial infarction complicated with ventricular arrhythmia

作　　者：李海玲 刘海云 LI Hailing;LIU Haiyun(Department of Cardiovascular Medicine,the Second People’s Hospital of Huaianthe Affiliated Huaian Hospital of Xuzhou Medical University,Jiangsu Province,Huaian 223022,China)

机构地区：[1]江苏省淮安市第二人民医院徐州医科大学附属淮安医院心血管内科,江苏淮安223022

出　　处：《中国医药导报》2024年第2期81-84,103,共5页China Medical Herald

基　　金：江苏省重点研发计划项目(BE2019651)。

摘　　要：目的探讨心电图结合血清肌酸激酶同工酶(CK-MB)水平对急性心肌梗死(AMI)并发室性心律失常(VA)的诊断价值。方法回顾性分析2019年5月至2022年7月江苏省淮安市第二人民医院收治的305例AMI患者的临床资料,根据患者是否并发VA分为VA组(124例)与非VA组(181例)。比较两组T波峰-末间期(Tp-Te)、经心率校正的Tp-Te间期(Tp-Tec)、血清CK-MB水平,分析AMI并发VA的影响因素,分析Tp-Te、Tp-Tec、血清CK-MB水平对AMI并发VA的诊断价值。结果VA组Killip心功能分级Ⅲ~Ⅳ级例数占比、肌钙蛋白I、血肌酐、白细胞计数、Tp-Te、Tp-Tec、血清CK-MB水平高于非VA组(P<0.05)。logistic回归结果显示,Killip心功能分级Ⅲ~Ⅳ级(OR=2.832)、Tp-Te升高(OR=3.611)、Tp-Tec升高(OR=4.315)、血清CK-MB升高(OR=3.770)为AMI并发VA的影响因素(P<0.05)。Tp-Te、Tp-Tec、血清CK-MB水平及三者联合诊断AMI并发VA的曲线下面积(AUC)值分别为0.790、0.802、0.813、0.895(P<0.05),且三者联合诊断的AUC值高于单独指标诊断的AUC值(P<0.05)。结论心电图(Tp-Te、Tp-Tec)结合血清CK-MB水平诊断AMI并发VA具有重要价值。Objective To explore the diagnostic value of electrocardiogram combined with serum creatine kinase isoenzyme(CK-MB)in acute myocardial infarction(AMI)complicated with ventricular arrhythmia(VA).Methods The clinical data of 305 patients with AMI admitted to the Second People’s Hospital of Huaian of Jiangsu Province from May 2019 to July 2022 were retrospectively analyzed,and the patients were divided into VA group(124 cases)and non-VA group(181 cases)according to whether they were complicated by VA.The T peak to end interval(Tp-Te),heart rate adjusted Tp-Te interval(Tp-Tec),and serum CK-MB levels were compared between the two groups,and the influencing factors of AMI complicated with VA were analyzed,and the diagnostic value of Tp-Te,Tp-Tec,and serum CK-MB levels in AMI complicated by VA was analyzed.Results The proportion of Killip cardiac function gradeⅢtoⅣcases,troponin I,serum creatinine,white blood cell count,Tp-Te,Tp-Tec,and serum CK-MB levels in VA group were higher than those in non-VA group(P<0.05).Logistic regression results showed that Killip cardiac function gradeⅢtoⅣ(OR=2.832),Tp-Te level(OR=3.611),Tp-Tec level(OR=4.315),and serum CK-MB level(OR=3.770)were the influential factors of AMI complicated with VA(P<0.05).The area under the curve(AUC)values of Tp-Te,Tp-Tec,and serum CK-MB levels and the combined diagnosis of AMI complicated with VA were 0.790,0.802,0.813,and 0.895,respectively(P<0.05),and the AUC value of the combined diagnosis was higher than that of the single diagnosis(P<0.05).Conclusion Electrocardiogram(Tp-Te,Tp-Tec)combined with serum CK-MB level has important value in the diagnosis of AMI complicated with VA.

关 键 词：心电图 肌酸激酶同工酶 急性心肌梗死 室性心律失常 诊断价值 

分 类 号：R54[医药卫生—心血管疾病]