摘要
目的:探讨心电图P波离散度(Pd)和红细胞分布宽度(RDW)与冠状动脉慢血流(CSF)的关系。方法:选取医院收治并经冠状动脉造影提示为CSF的103例患者纳入观察组,同时选择同期冠状动脉造影正常的58例患者纳入正常组,测定两组RDW与心电图Pd变化,并分析比较两组生化指标、Pd及RDW与冠状动脉平均血流帧数(TFC)差异。采用Pearson相关性分析Pd、RDW与冠状动脉心肌梗死溶栓试验(TIMI)的TFC值的相关性,采用受试者工作特征(ROC)曲线评估Pd、RDW对CSF发生的诊断价值,采用多因素Logistic回归分析CSF发生的影响因素。结果:观察组患者Pd、RDW均高于正常组,差异有统计学意义(t=7.353,t=8.770;P<0.05);LAD、LCX及RCA的TFC值以及平均TFC值均高于正常组,差异有统计学意义(t=15.162,t=11.680,t=13.663,t=13.296;P<0.05);Pd与LAD、LCX及RCA的TFC值以及平均TFC值均呈正相关(r=0.620,r=0.541,r=0.452,r=0.515;P<0.05);RDW与LAD、LCX及RCA的TFC值以及平均TFC值均呈正相关(r=0.352,r=0.417,r=0.510,r=0.462;P<0.05);Pd预测CSF的ROC曲线下面积(AUC)、灵敏度和特异度分别为0.789、85.2%和88.9%;RDW预测CSF的AUC、灵敏度和特异度分别为0.778、83.7%和90.6%。多因素Logistic回归分析,Pd和RDW均为影响CSF发生的危险因素(OR=3.50,OR=3.93;P<0.05)。结论:CSF患者心电图Pd增大,RDW水平升高,并且Pd、RDW与冠状动脉TIMI的TFC值呈正相关,二者可作为预测CSF发生的有效生物标志物。
Objective: To investigate the relationship between P-wave dispersion(Pd) of electrocardiograph(ECG and red blood cell distribution width RDW) and the phenomenon of coronary slow flow(CSF). Methods: 103 CSF patients who admitted to hospital and were confirmed by coronary angiography were selected as the observation group,and 58 patients whose coronary angiography were normal in the same period were selected as the normal group. Then the changes of RDW and ECG PD of the two groups were measured, and the differences of biochemical indexes, Pd,RDW and average flow frames counts(TFC) between the two groups were analyzed and compared. Pearson correlation analysis was used to explore the correlations between PD, RDW and TFC value of thrombolysis in myocardial infarction(TIMI). The receiver operating characteristic(ROC) curve was used to assess the diagnostic value of Pd and RDW in the occurrence of CSF. Multivariate logistic regression was used to analyze the influencing factors of occurring CSF. Results: The Pd and RDW of the patients in the observation group were significantly higher than those in the normal group(t=7.353, t=8.770, P<0.05), respectively. The TFC values and average TFC values of left anterior descending(LAD) branch, left circumflex artery(LCX) and right coronary artery(RCA) in the observation group were significantly higher than those in the normal group(t=715.162, t=11.680, t=13.663, t=13.296, P<0.05),respectively. Pd was positively correlated with the TFC values of LAD, LCX and RCA, and with the average TFC value of them(r=0.620, r=0.541, r=0.452, r=0.515, P<0.05), and RDW was positively correlated with the TFC values of LAD, LCX and RCA, and with the average TFC value of them(r=0.352, r=0.417, r=0.510, r=0.462, P<0.05),respectively. The area under curve(AUC) of ROC curve, sensitivity and specificity of Pd were 0.789, 85.2%, and 88.9%in predicting CSF, respectively. These indicators of RDW were 0.778, 83.7% and 90.6%, respectively. The results of multivariate logistic regression analysis showed that
作者
吴敏
吴婧
张雅玲
毛英
王红艳
曹桂秋
WU Min;WU Jing;ZHANG Ya-ling(Department of Cardiology,The Fifth Affiliated Hospital of Xijiang Medical University,Urumqi 830000,China.)
出处
《中国医学装备》
2023年第2期63-67,共5页
China Medical Equipment
基金
新疆维吾尔自治区自然科学基金(2021D01C450)“无创迷走神经刺激参数优化对冠脉慢血流现象治疗效果观察及机制研究”。
