摘要
目的探究冠心病(CHD)心绞痛患者QT离散度(QTd)、T波峰-末(T_(p)-T_(e))间期、T_(p)-T_(e)/QT比值、心率变异性(HRV)水平变化及其与冠脉病变严重程度的关系。方法选择2018年8月至2021年10月在宝鸡市人民医院就诊的98例CHD心绞痛患者作为研究组,根据冠脉病变程度分为轻度组34例、中度组40例和重度组24例,选择同期来我院检查的非CHD心绞痛患者60例作为对照组。CHD心绞痛患者均经PCI治疗,收集两组患者的一般资料,比较对照组和研究组患者PCI手术前后的QTd、T_(p)-T_(e)间期、T_(p)-T_(e)/QT比值、HRV及心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平,采用Pearson相关性分析心电指标与术前心肌酶谱指标及冠脉病变严重程度的关系。结果研究组患者术前的cTnI、CK-MB、QTd、T_(p)-T_(e)间期以及T_(p)-T_(e)/QT比值水平明显高于对照组,术后的cTnI、CK-MB、QTd、T_(p)-T_(e)间期以及T_(p)-T_(e)/QT比值虽然明显低于其术前,但仍明显高于对照组,差异均有统计学意义(P<0.05);研究组患者术前的HRV各参数水平明显低于对照组,术后,研究组患者的HRV各参数水平虽然明显高于其术前,但仍明显低于对照组,差异均有统计学意义(P<0.05);术后,三组不同冠脉病变程度患者的QTd、T_(p)-T_(e)间期、T_(p)-T_(e)/QT比值随着冠脉病变程度的增加而升高,HRV各参数水平随着冠脉病变程度的增加而降低,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,QTd、T_(p)-T_(e)间期、T_(p)-T_(e)/QT比值与cTnI、CK-MB水平、冠脉病变严重程度均呈正相关(P<0.05),HRV各参数与cTnI、CK-MB水平、冠脉病变严重程度均呈负相关(P<0.05)。结论CHD心绞痛患者的心肌酶谱、QTd、T_(p)-T_(e)间期、T_(p)-T_(e)/QT比值及HRV各参数水平均出现异常,CHD心绞痛患者PCI术后的各心电指标与患者术前心肌损伤、冠脉病变严重程度均相关。
Objective To explore the changes of QT dispersion(QTd),Tpeak-Tend(T_(p)-T_(e))interval,T_(p)-T_(e)/QT ratio,and heart rate variability(HRV),and their relationship with the severity of coronary lesions in patients with angina pectoris of coronary heart disease(CHD).Methods A total of 98 patients with angina pectoris of CHD treated in Baoji People's Hospital between August 2018 and October 2021 were enrolled as study group.According to the severity of coronary lesions,they were divided into mild group(34 cases),moderate group(40 cases),and severe group(24 cases).A total of 60 individuals without angina pectoris of CHD during the same period were enrolled as control group.All patients with angina pectoris of CHD underwent PCI.The general data in the two groups were collected.The levels of QTd,T_(p)-T_(e) interval,T_(p)-T_(e)/QT ratio,HRV,cardiac troponin I(cTnI),and creatine kinase MB(CK-MB)were compared between study group and control group before and after PCI.The relationship between ECG indexes and preoperative myocardial enzyme indexes,the severity of coronary lesions was analyzed by Pearson correlation analysis.Results Before surgery,cTnI,CK-MB,QTd,T_(p)-T_(e) interval,and T_(p)-T_(e)/QT ratio in the study group were significantly higher than those in the control group(P<0.05).After surgery,cTnI,CK-MB,QTd,T_(p)-T_(e) interval,and T_(p)-T_(e)/QT ratio in the study group were significantly decreased,which were significantly higher than those in the control group(P<0.05).Before surgery,levels of HRV parameters in the study group were significantly lower than those in control group.After surgery,levels of HRV parameters in the study group were significantly increased,which were significantly lower than those in control group(P<0.05).After surgery,with the aggravation of coronary lesions,QTd,T_(p)-T_(e) interval,and T_(p)-T_(e)/QT ratio were increased,while levels of HRV parameters were decreased in patients with different severity of coronary lesions(P<0.05).Pearson correlation analysis showed that QTd,T_(p)-T_(e)
作者
杨菲
李汉丽
李易
YANG Fei;LI Han-li;LI Yi(Department of Function,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;ECG Room,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第21期2726-2729,共4页
Hainan Medical Journal
基金
陕西省西安市科技计划项目(编号:2017114SF/YX008【5】)。
