老年慢性心衰患者血清cTnI、CK-MB水平与心电图QRS波的相关性研究

Relationship between serum cTnI level and ECG QRS wave,and between serum CK-MB level and ECG QRS wave in elderly patients with chronic heart failure

目的:分析老年慢性心力衰竭(CHF)患者血清心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)与心电图QRS波的相关性。方法:选取2020年9月至2023年10月六安市中医院接收的100例老年CHF患者,将其纳入观察组,另选同期于本院进行体检的100名老年健康者纳入健康对照组。所有受检者均接受血清cTnI、CK-MB检查及心电图检查,比较两组受检者的QRS波时限、血清cTnI、CK-MB水平。100例观察组患者再根据心电图QRS波时限是否异常分为两个亚组,即QRS异常组(52例,QRS波时限≥120 ms)和QRS正常组(48例,QRS波时限<120 ms);比较两个亚组患者一般资料,血清cTnI、CK-MB水平;分析老年CHF患者血清c Tn I、CK-MB水平与心电图QRS波的相关性。结果:与健康对照组比较,观察组血清c Tn I(1.912±0.401 vs. 0.861±0.173)μg/L、CK-MB(23.272±4.801 vs. 10.573±2.332)U/L水平更高,QRS波时限更长(126.761±17.452 vs. 104.475±13.351)μg/L,两组比较差异有统计学意义(t=24.159、23.802、10.145,P<0.05)。观察组患者经心电图检查发现,有52例患者出现心电图QRS波时限异常,QRS波时限平均为(141.641±12.581)ms;48例患者心电图QRS波时限正常,QRS波时限平均为(110.652±10.751)ms。QRS波时限异常组患者的血清c Tn I、CK-MB水平均高于QRS正常组患者,差异有统计学意义(t=7.534、10.362,P<0.05);经一般线性双变量Pearson检验结果显示,c Tn I、CK-MB两项血清指标与QRS波时限均呈正相关(r=0.395、0.453,P<0.05)。经logistic回归分析结果显示,血清c Tn I、CK-MB水平与心电图QRS波时限有关,过表达可能是心电图QRS波时限异常的风险因子(OR=4.444、1.445,P<0.05)。结论:老年CHF患者血清c Tn I、CK-MB水平异常升高,二者过表达与心电图QRS波时限异常有关,可能是QRS波时限异常的风险因子。

Objective:To analyze the correlation between serum cardiac troponin I(cTnI)and electrocardiogram(ECG)QRS wave,and between creatine kinase isoenzyme MB(CK-MB)and ECG QRS wave in elderly patients with chronic heart failure(CHF).Methods:A total of 100 elderly CHF patients who admitted to Lu’an Hospital of Traditional Chinese Medicine of Anhui Province from September 2020 to October 2023 were selected as the observation group,and a total of 100 elderly healthy patients who underwent physical examination during the same period were selected as the control group.All of them received examinations of serum cTnI,CK-MB and ECG.The time limit of QRS wave,serum cTnI and CK-MB levels between control group and observation group were compared.The patients of the observation group were further divided into two subgroups based on whether occurred abnormal time limit of QRS wave,which included abnormal QRS wave group(52 cases,time limit of QRS wave≥120 ms)and normal QRS wave group(48 cases,time limit of QRS wave<120 ms).The general data,serum cTnI and CK-MB levels between the two groups were compared,and the correlations between serum cTnI level and ECG QRS wave,and between CK-MB level and ECG QRS wave in elderly CHF patients were analyzed.Results:Compared with serum cTnI(0.861±0.173),CKMB(10.573±2.332)and time limit of QRS wave(104.475±13.351)of control group,the serum cTnI(1.912±0.401)and CK-MB(23.272±4.801)of observation group were higher,and the time limit of QRS wave(126.761±17.452)was longer,and the differences of them between two groups were statistically significant(t=24.159,23.802,10.145,P<0.05),respectively.The ECG examination of observation group found that 52 patients occurred abnormal time limit of ECG QRS wave,and the average time limit of QRS wave of them was(141.641±12.581)ms,and 48 patients had normal time limit of ECG QRS wave,and the average time limit of QRS wave of them was(110.652±10.751)ms.The serum cTnI and CK-MB levels of patients in abnormal time limit of QRS wave were higher than these of patients in normal time limit of QRS wave,and the difference was statistically significant(t=7.534,10.362,P<0.05),respectively.The result of general linear bivariate Pearson-test indicated that serum cTnI and CK-MB were positively correlated with time limit of QRS wave(r=0.395,0.453,P<0.05),respectively.The result of logistic regression analysis indicated that serum cTnI and CK-MB levels were related to the time limit of ECG QRS wave,which overexpression might be risk factor for abnormal time limit of ECG QRS wave(OR=4.444,1,445,P<0.05).Conclusion:The serum cTnI and CK-MB levels of elderly CHF patients are abnormally high,and the overexpression of the two indicators is related to abnormal time limit of ECG QRS wave,which might be risk factor of abnormal time limit of QRS wave.