老年初诊冠心病患者动态心电图特征及LDH、CK-MB、NBP检测结果分析

Analysis of dynamic electrocardiogram characteristics and detection results of LDH,CK-MB and NBP in elderly patients with newly diagnosed coronary heart disease

中文关键词: 老年  冠心病  动态心电图  乳酸脱氢酶  肌酸激酶同工酶  无创血压

英文关键词: elderly  coronary heart disease  dynamic electrocardiogram  lactate dehydrogenase  creatine kinase isoenzyme  non-invasive blood pressure

中文摘要:

      目的 探究老年初诊冠心病患者的动态心电图特征及血清乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、无创血压(NBP)与冠心病严重程度的关系,并评估其临床诊断价值.方法 回顾性分析2020年3月—2023年6月于合肥京东方医院体检的107名老年受试者的临床资料,依据是否诊断为冠心病分为冠心病组(n=67)与对照组(n=40).比较2组动态心电图特征、血清LDH和CK-MB水平、NBP异常率,分析其与冠心病严重程度的相关性.根据Gensini评分,将67例冠心病患者分为轻症亚组[n=39,58.21％,评分(35.62±4.01)分]和重症亚组[n=28,41.79％,评分(46.37±4.85)分].结果 冠心病组ST段改变、房性及室性早搏检出率,血清LDH和CK-MB水平,NBP异常率均高于对照组,差异均有统计学意义(P＜0.05).重症亚组血清LDH和CK-MB水平、NBP异常率均高于轻症亚组,差异均有统计学意义(P＜0.05).Spearman相关分析显示,血清LDH和CK-MB水平、NBP异常率与病情严重程度呈正相关(P＜0.05).ROC曲线表明,血清LDH和CK-MB水平、NBP异常率联合诊断冠心病的AUC为0.880,优于单一指标(P＜0.05).结论 老年初诊冠心病患者的动态心电图异常包括ST段改变、房性及室性早搏,其血清LDH和CK-MB水平、NBP检测值与冠心病病情严重程度可能显著相关,且3项指标联合对评估病情严重程度具有较高的诊断价值.

英文摘要:

      Objective To explore the dynamic electrocardiogram characteristics and the detection results of lactate dehy-drogenase(LDH),creatine kinase isoenzyme(CK-MB),and non-invasive blood pressure(NBP)in elderly patients with newly diagnosed coronary heart disease(CHD),analyze the relationship between these markers and the severity of CHD,and assess their clinical diagnostic value.Methods A retrospective analysis was conducted on the clinical data of 107 elderly sub-jects who underwent physical examinations in Hefei BOE Hospital from March 2020 to June 2023.They were divided into CHD group(n=67)and control group(n=40)based on whether they were diagnosed with CHD.The characteristics of ambulatory electrocardiogram,the levels of serum LDH and CK-MB,and the abnormal rate of NBP were compared between the two groups and their correlations with the severity of CHD were analyzed.According to the Gensini score,67 CHD patients were divided into mild subgroup[n=39,58.21％,score(35.62±4.01)points]and severe subgroup[n=28,41.79％,score(46.37±4.85)points].Results The detection rate of ST segment changes,atrial and ventricular premature beats,levels of serum LDH and CK-MB,and abnormal rate of NBP in the CHD group were significantly higher than those in the control group,and the differences were statistically significant(P＜0.05).The levels of serum LDH and CK-MB and the abnormal rate of NBP in the severe subgroup were significantly higher than those in the mild subgroup,and the differences were statisti-cally significant(P＜0.05).Spearman correlation analysis showed that the levels of serum LDH and CK-MB and the abnormal rate of NBP were positively correlated with the severity of the disease(P＜0.05).The ROC curve indicated that the AUC of the combined diagnosis of CHD by the levels of serum LDH and CK-MB and the abnormal rate of NBP was 0.880,which was superior to any single indicator(P＜0.05).Conclusion The dynamic electrocardiogram abnormalities of elderly patients with newly diagnosed CHD include ST segment changes,atrial and ventricular premature beats.The levels of serum LDH and CK-MB,and NBP detection values may be significantly correlated with the severity of CHD,and the combination of the three indi-cators has high diagnostic value in evaluating the severity of the disease.