冠心病患者动态心电图参数、血清Syndecan-4水平与冠脉病变程度的相关性分析及临床意义  

Correlation Analysis and Clinical Significance of Holter Electrocardiogram Parameters,Serum Syndecan-4 Level and Coronary Lesion Degree in Patients with Coronary Heart Disease

作　　者：潘亚琼 张志 程海 张恒源 PAN Yaqiong;ZHANG Zhi;CHENG Hai(Department of Cardiopulmonary Function,Zhengzhou Yihe Hospital,Zhengzhou City,He’nan Province 450000;不详)

机构地区：[1]郑州颐和医院心肺功能科,河南省郑州市450000 [2]郑州市人民医院心功能科 [3]鹤壁市人民医院电生理科 [4]河南省人民医院心功能科

出　　处：《医学理论与实践》2024年第20期3440-3443,共4页The Journal of Medical Theory and Practice

基　　金：河南省医学科技攻关联合共建项目(LHGJ20191180)。

摘　　要：目的:探讨冠心病患者动态心电图参数、血清多配体蛋白聚糖4(Syndecan-4)水平与冠脉病变程度相关性,并分析其对经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)发生的预测价值。方法:回顾性选取2021年6月—2023年7月本院收治的132例冠心病患者作为研究组,另选取同期健康志愿者44例作为对照组。比较两组动态心电图参数[全程全部NN间期标准差(SDNN)、24h内每5min NN间期均值的标准差(SDANN)、全程相邻NN间期之差的均方根值(rMSSD)]、血清Syndecan-4水平。依据不同病变支数分为单支病变46例、双支病变31例、多支病变55例;依据冠脉病变程度分为轻度43例、中度59例、重度30例,比较其动态心电图参数、血清Syndecan-4水平。分析动态心电图参数、血清Syndecan-4水平与病变支数、冠脉病变程度相关性。研究组予以PCI治疗,依据术后6个月是否发生MACE分为发生者31例、未发生者101例,比较其术前、术后14d动态心电图参数、血清Syndecan-4水平。评价术后14d动态心电图参数、血清Syndecan-4水平对术后6个月MACE发生的预测价值。结果:研究组SDNN、SDANN、rMSSD低于对照组,血清Syndecan-4水平高于对照组(P<0.05);随着病变支数增加、冠脉病变程度加重,SDNN、SDANN、rMSSD呈下降趋势,血清Syndecan-4水平呈上升趋势(P<0.05);SDNN、SDANN、rMSSD与病变支数、冠脉病变程度呈负相关,Syndecan-4与之相反(P<0.05);发生者术后14d SDNN、SDANN、rMSSD低于未发生者,Syndecan-4水平高于未发生者(P<0.05);术后14d SDNN、SDANN、rMSSD、血清Syndecan-4联合预测PCI术后6个月MACE发生的AUC大于单项指标预测(P<0.05)。结论:冠心病患者SDNN、SDANN、rMSSD降低,血清Syndecan-4水平升高,且与冠脉病变严重程度密切相关,联合检测其水平对PCI术后MACE发生具有一定预测价值。Objective:To investigate the correlation between dynamic electrocardiogram parameters,serum Syndecan-4 level and the degree of coronary artery disease in patients with coronary heart disease,and to analyze its predictive value for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI).Methods:A total of 132 patients with coronary heart disease admitted to our hospital from June 2021 to July 2023 were selected as the study group,and 44 healthy volunteers were selected as the control group.The parameters of holter electrocardiogram[standard deviation of NN interval throughout(SDNN),standard deviation of NN interval mean value every 5 minutes within 24 hours(SDANN),root mean square value of difference between NN intervals throughout adjacent NN interval(rMSSD)]and serum Syndecan-4 level were compared between the two groups.There were 46 cases of single branch disease,31 cases of double branch disease and 55 cases of multiple branch disease.According to the degree of coronary disease,43 cases were divided into mild cases,59 cases were moderate cases and 30 cases were severe cases.The dynamic electrocardiogram parameters and serum Syndecan-4 levels were compared.The correlation of holter ECG parameters,serum Syndecan-4 level with the number of lesions and the degree of coronary lesions was analyzed.According to the occurrence of MACE 6 months after surgery,the study group was divided into 31 cases with MACE occurrence and 101 cases without MACE occurrence.Dynamic electrocardiogram parameters and serum Syndecan-4 levels were compared before surgery and 14 days after surgery.To evaluate the predictive value of holter ECG parameters and serum Syndecan-4 level on the occurrence of MACE at 14 days after surgery.Results:SDNN,SDANN and rMSSD in the study group were lower than those in the control group,and serum Syndecan-4 level was higher than that in the control group(P<0.05).SDNN,SDANN and rMSSD decreased with the increase of the number of lesions and the severity of coronary lesions,while

关 键 词：冠心病 动态心电图 多配体蛋白聚糖4 经皮冠状动脉介入治疗 预测 

分 类 号：R541.4[医药卫生—心血管疾病]