摘要
目的探讨心电图与空腹血糖、C-反应蛋白、白介素-6、肿瘤坏死因子-α及内脂素水平变化在急性下壁心肌梗死中的诊断价值。方法急性下壁心肌梗死患者50例,入院后第一天行12导联心电图检查,并择期对患者进行冠状动脉造影检查。分析心电图不同导联ST段偏移情况,将其结果与冠状动脉造影结果进行对比。选择健康查体53例作对照。对照组查体时、患者入院后第一天抽晨起静脉血检测血常规、空腹血糖、C-反应蛋白、白介素-6、肿瘤坏死因子-α及内脂素水平。应用SPSS17.0软件,所获数据采用方差分析、t检验和X^2检验。结果心电图判断梗死病变血管,右冠状动脉32例,占64.00%;回旋支18例,占36%。右冠状动脉与回旋支发生率比较,P<0.01。与冠状动脉造影完全相符。急性下壁心肌梗死组与健康对照组的空腹血糖、C-反应蛋白、白介素-6、肿瘤坏死因子-α及内脂素水平比较,P均<0.0005。对于空腹血糖低、中两组,血糖水平对周围血白细胞影响的比较,P<0.001;血糖水平对周围血中性粒细胞、淋巴细胞、中性粒细胞/淋巴细胞比值影响的比较,P均<0.0005。对于空腹血糖低、高两组,血糖水平对周围血白细胞、中性粒细胞、淋巴细胞、中性粒细胞/淋巴细胞比值影响的比较,P均<0.0005。对于空腹血糖中、高两组,血糖水平对周围血白细胞影响的比较,P<0.05;血糖水平对周围血中性粒细胞影响的比较,P<0.005;血糖水平对周围血淋巴细胞、中性粒细胞/淋巴细胞比值影响的比较,P均<0.0005。结论急性下壁心肌梗死时心电图有助于鉴别冠状动脉病变支,空腹血糖、C-反应蛋白、白介素-6、肿瘤坏死因子-α及内脂素水平变化均有助于判断患者的严重程度及预后。
Objective To explore the diagnostic value of electrocardiogram （ECG）, fasting blood glucose （FBG）, C- reactive protein （CRP）, interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α ） and visfatin level in patients with acute in- ferior wall myocardial infarction （AIMI）. Methods Fifty patients with acute inferior wall myocardial infarction were per- formed 12-lead ECG at the first day after admission and coronary angiography at regular intervals. ST segment deviation in different leads of electrocardiogram was analyzed and the results were compared with those of coronary angiography. 53 healthy subjects were selected as the control group. Blood routine, FBG, CRP, IL-6, TNF-α and visfatin levels were mea- sured in the control group. The data was analyzed by SPSS17.0 software, t test and Z2 test. Results According to the ECG,32 cases （64.00 %） had infarction in right coronary artery and 18 cases （36 %） were in circumflex branches. The incidence of right coronary artery and circumflex branch was compared with P〈0.01, which was completely consistent with coronary angiography. The comparison of FBG, CRP, IL-6, TNF-α and visfatin levels between the two groups was P〈0.0005. For patients with low or middle FBG, the effect of FBG on leukocytes of peripheral blood was compared with P〈0.001; the effects of FBG on neutrophils, lymphocytes and ratio of neutrophils and lymphocytes in peripheral blood were compared with P〈0.0005. For patients with low or high FBG, the effects of FBG on leukocytes, neutrophils, lymphocytes, neutrophils/lym- phocytes ratio in peripheral blood were compared with P〈0.0005. For patients with low or high FBG, the effect of FBG on leukocytes of peripheral blood was compared with P〈0.05; the effect of FBG on neutrophils was compared with P〈0.005; the effects of FBG on lymphocytes and neutrophils/lymphocytes ratio in peripheral blood were compared with P〈0.0005. Conclusion ECG is helpful to identify the changes of coronary artery branches in acute inferio
出处
《菏泽医学专科学校学报》
2017年第4期13-16,共4页
Journal of Heze Medical College
