急性心肌梗死患者CK-MB、MYO水平变化与心率减速力及心率变异性的相关性研究  

Changes of CK-MB and MYO levels and their correlation with heart rate deceleration capacity and heart rate variability in patients with acute myocardial infarction

作　　者：李容[1] 李礼芳 LI Rong;LI Li-fang(Department of Electrocardiogram Diagnosis,People's Hospital of Baise,Baise,Guangxi Zhuang Autonomous Region,533000,China)

机构地区：[1]百色市人民医院心电诊断科,广西百色533000

出　　处：《心血管康复医学杂志》2025年第1期12-16,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2023年百色市科学研究与技术开发计划项目(百科20230585)。

摘　　要：目的:探讨急性心肌梗死(AMI)患者肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)水平与心率减速力(DC)、心率变异性(HRV)的相关性。方法:将百色市人民医院2022年7月至2023年6月收治的临床资料完整的117例AMI患者纳入研究,作为观察组,另选择本院同期接收的117名健康体检者作为对照组。对比两组CK-MB、MYO水平;采用受试者工作特征曲线(ROC)分析CK-MB、MYO及其联合检测对AMI的诊断价值;比较两组DC和HRV;采用Pearson相关性分析CK-MB、MYO与DC、HRV指标的相关性。结果:与对照组比较,观察组CK-MB[(35.27±20.27)U/L比(18.06±3.65)U/L]、MYO[(233.88±13.83)μg/L比(30.87±5.08)μg/L]显著更高(P均<0.001);DC[(5.67±2.59)ms比(7.62±1.12)ms]、连续心率减速力2(DR2)[(8.07±0.69)%比(9.13±0.98)%]、连续心率减速力4(DR4)[(0.41±0.10)%比(0.81±0.15)%]、正常窦性RR间期的标准差(SDNN)[(80.24±27.82)ms比(142.45±16.79)ms]、每5 min窦性R-R间期均值的标准差(SDANN)[(67.25±24.47)ms比(115.12±12.18)ms]、24 h内所有相邻窦性R-R间期差值的均方根(RMSSD)[(25.64±17.37)ms比(37.37±5.93)ms]均显著降低(P均<0.001)。ROC分析显示,联合检测诊断的曲线下面积(AUC)为0.881,显著高于单一检测(Z=5.284、5.317,P均<0.001)。Pearson相关性分析显示,CK-MB与DC、DR2、DR4、SDNN、SDANN、RMSSD均呈显著负相关(r=-0.453~-0.639,P<0.05或<0.01);MYO与上述指标均呈显著负相关(r=-0.438~-0.840,P<0.05或<0.01)。结论:CK-MB、MYO对AMI具有一定诊断价值,但联合检测的诊断效能更高,并且CK-MB、MYO与DC和HRV指标均呈显著负相关。Objective:To investigate the association of levels of creatine kinase isoenzyme(CK-MB),myoglobin(MYO)with heart rate deceleration capacity(DC)and heart rate variability(HRV)in patients with acute myocardial infarction(AMI).Methods:A total of 117 AMI patients with complete clinical data admitted in People's Hospital of Baise between July 2022 and June 2023 were included as the observation group,and 117 healthy subjects who received physical examination in our hospital simultaneously were selected as the control group.The CK-MB and MYO levels were compared between the two groups.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of CK-MB,MYO and their combined detection for AMI.The DC and HRV were compared between the two groups.Pearson correlation analysis was used to analyze the association of CK-MB,MYO with DC and HRV indexes.Results:Compared with participants in control group,patients in observation group had significant higher CK-MB[(35.27±20.27)U/L vs.(18.06±3.65)U/L]and MYO[(233.88±13.83)μg/L vs.(30.87±5.08)μg/L](P<0.001 all),and significant lower DC[(5.67±2.59)ms vs.(7.62±1.12)ms],heart rate deceleration run(DR)2[(8.07±0.69)%vs.(9.13±0.98)%],DR4[(0.41±0.10)%vs.(0.81±0.15)%],standard deviation of NN intervals(SDNN)[(80.24±27.82)ms vs.(142.45±16.79)ms],standard deviation of mean sinus R-R interval every 5 min(SDANN)[(67.25±24.47)ms vs.(115.12±12.18)ms],root mean square of successive differences(RMSSD)[(25.64±17.37)ms vs.(37.37±5.93)ms](P<0.001 all).ROC analysis indicated that the area under the diagnostic curve(AUC)of combined detection(0.881)was significantly higher than those of single detection(Z=5.284,5.317,P<0.001 all).Pearson correlation analysis showed that CK-MB was significantly negatively correlated with DC,DR2,DR4,SDNN,SDANN and RMSSD(r=-0.453~-0.639,P<0.05 or<0.01).There was a significant negative correlation between MYO and above-mentioned indexes(r=-0.438~-0.840,P<0.05 or<0.01).Conclusion:CK-MB and MYO have certain diagnostic value for AMI,but

关 键 词：心肌梗死 肌酸激酶 MB型 肌红蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]