心肌复极异常心电图表现与冠心病患者心肌酶谱指标的关系研究

摘要

目的 探究心肌复极异常心电图表现与冠心病患者心肌酶谱指标的关系.方法 选取2015年6月一2016年4月在清河县中心医院就诊的冠心病患者198例,分为稳定型心绞痛(SAP)组45例、不稳定型心绞痛(UAP)组78例、急性心肌梗死(AMI)组75例,另选取同期在本院体检健康者40例作为对照组.比较4组受试者心肌复极异常心电图表现及心肌酶谱指标[天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及乳酸脱氢酶(LDH)],并比较不同心肌复极异常心电图表现患者心肌酶谱指标.结果 AMI组、UAP组和SAP组患者ST段异常、T波异常发生率高于对照组,AMI组和UAP组患者ST段异常、T波异常发生率高于SAP组,AMI组患者ST段异常、T波异常发生率高于UAP组(P＜0.05);AMI组患者V2导联Tp-Te间期长于UAP组、SAP组和对照组(P＜0.05).SAP组患者血清CK水平高于对照组(P＜0.05),而SAP组患者与对照组受试者血清AST、CK-MB、LDH水平比较,差异无统计学意义(P＞0.05);AMI组和UAP组患者血清AST、CK、CK-MB及LDH水平高于对照组,AMI组患者血清AST、CK和CK-MB水平高于UAP组(P＜0.05),而AMI组和UAP组患者血清LDH水平比较,差异无统计学意义(P＞0.05).ST段异常患者血清AST、CK、CK-MB及LDH水平高于无ST段异常患者,T波异常患者血清AST、CK、CK-MB及LDH水平高于无T波异常患者(P＜0.05).结论 心肌复极异常心电图表现与冠心病患者心肌酶谱指标升高有关.%Objective To explore the relationship between electrocardiographic findings of irregular myocardium repolarization and myocardial enzymes indicators of patients with coronary heart disease.Methods A total of 198 patients with coronary heart disease were selected in the Central Hospital of Qinghe County from June 2015 to April 2016,thereinto 45 cases with stable angina pectoris were served as A group,78 cases with unstable angina pectoris were served as B group,75 cases with acute myocardial infarction were served as C group;meanwhile 40 healthy individuals admitted to this hospital for physical examination were selected as control group.Electrocardiographic findings of irregular myocardium repolarization and myocardial enzymes indicators (including AST,CK,CK-MB and LDH) were compared among the four groups,meanwhile myocardial enzymes indicators were compared in patients with different electrocardiographic findings of irregular myocardium repolarization.Results Incidence of ST-segment abnormality and T wave abnormality of A group,B group and C group was statistically significantly higher than that of control group,respectively,incidence of ST-segment abnormality and T wave abnormality of B group and C group was statistically significantly higher than that of A group,respectively,meanwhile incidence of ST-segment abnormality and T wave abnormality of C group was statistically significantly higher than that of B group respectively (P ＜0.05);Tp-Te interval in lead V2 of C group was statistically significantly longer than that of A group,B group and C group respectively (P ＜0.05).Serum CK level of A group was statistically significantly higher than that of control group,while no statistically significant differences of serum level of AST,CK-MB or LDH was found between A group and control group (P ＞ 0.05);serum levels of AST,CK,CK-MB and LDH of B group and C group were statistically significantly higher than those of control group,serum levels of AST,CK and CK-MB of C group were statistically significantly higher than those of B group (P ＜0.05),while no statistically significant differences of serum LDH level was found between B group and C group (P ＞0.05).Serum levels of AST,CK,CK-MB and LDH of patients with ST-segment abnormality were statistically significantly higher than those of patients without ST-segment abnormality,serum levels of AST,CK,CK-MB and LDH of patients with T wave abnormality were statistically significantly higher than those of patients without T wave abnormality (P ＜ 0.05).Conclusion Electrocardiographic findings of irregular myocardium repolarization are correlated with elevation of myocardial enzymes indicators of patients with coronary heart disease.