冠心病伴有自主神经功能损伤患者内源性人体促红细胞生成素水平与心电散点图变化的相关性

Correlation between endogenous EPO levels and electrocardiogram scatter plot changes in patients with coronary heart disease and autonomic nerve function injury

目的分析冠心病伴有自主神经功能损伤患者内源性红细胞生成素(EPO)水平与心电散点图变化的相关性。方法选择2015年7—10月就诊于泰山医学院附属医院行冠状动脉造影术(CAG)检查的确诊慢性稳定性冠心病患者48例,行Ewing标准自主神经功能测试并行动态心电图检查。收集患者临床资料,抽取静脉血检测EPO水平。结果根据Ewing法评分标准,48例患者分为Ewing(+)组和Ewing(-)组。Ewing(+)组患者EPO水平[(13±3)mIU/ml]明显高于Ewing(-)组[(10±3)mIU/ml];两组患者Lorenz散点图彗星状比较差异有统计学意义,Lorenz散点图定量指标比较,Ewing(+)组长度[(147±22)ms]低于Ewing(-)组[(164±24)ms],差异有统计学意义,宽度两组间比较差异无统计学意义。两组患者EPO水平与长度呈负相关(r=-0.427,P=0.002),与宽度无相关性(r=0.091,P=0.539);以自主神经功能是否受损[Ewing(+)组=1,Ewing(-)组=0]为因变量,行二分类Logistic回归分析提示EPO(OR=1.394)、舒张压(OR=1.091)是自主神经功能受损的危险因素,长度(OR=0.934)是自主神经功能的保护因素;以自主神经功能受损为状态变量行ROC曲线分析,EPO曲线下面积为0.737,以自主神经功能未受损为状态变量的长度曲线下面积为0.719。结论冠心病伴有自主神经功能损伤患者内源性EPO水平与心电散点图的变化具有相关性,在预测自主神经功能是否受损方面,EPO与长度具有相似的诊断价值。

Objective To analyze the correlation between endogenous EPO levels and electrocardiogram scatter plot changes in patients with coronary heart disease and autonomic nerve function injury.Methods Forty-eight patients who underwent coronary arteriography (CAG) inspection due to chronic coronary heart diseases were selected from July 2015 to October 2015.All of them were evaluated by the Ewing standard autonomic nervous function test,and were divided into Ewing(+) group and Ewing(-) group according to the results of the test.The clinical data of the patients was collected and venous blood was extracted to detect EPO level.Results The EPO level of Ewing (+) group ((13±3) mIU/ml) was significantly higher than that of Ewing (-) group ((10±3) mIU/ml).The Lorenz scatter plot comet shapes between the two groups had a significant difference.As for the quantitative indicators of Lorenz scatterplot,length of the Ewing (+) group ((147±22) ms) was shorter than that of the Ewing (-) group ((164±24) ms) and there was no significant differences in the width between the two groups.EPO level was negatively correlated with length in both groups (r=-0.427,P=0.002),but not with width (r=0.091,P=0.539).Binary logistic regression analysis showed that EPO (OR=1.394) and diastolic blood pressure (OR=1.091) were risk factors for autonomic nervous function damage.Length (OR=0.934) was a protective factor for autonomic nervous function.ROC curve analysis showed that the area under the EPO curve was 0.737 and that under the length curve was 0.719.Conclusions The endogenous EPO levels are associated with the changes of electrocardiogram scatter plot in patients with coronary heart disease and autonomic nerve function injury.EPO and length of scatter plot have the similar diagnostic value on predicting of autonomic nerve function injury.