血清Cys-C与HRV联合诊断冠心病心衰的研究

Clinical value of combined heart rate variability parameters and Cys-C levels in the diagnosis of coronary heart disease and heart failure

目的本研究旨在探究动态心电图的HRV(心率变异性)指标联合Cys-C检测联合诊断冠心病并心力衰竭的价值。方法收集2016年3月到2018年3月我院收治的70例冠心病合并心力衰竭患者设为研究组,同期收集门诊健康体检者70例为对照组。患者均进行动态心电图HRV值以及血清Cys-C水平的检测,比较两组间的HRV指标及Cys-C水平的差异,并对二者联合检测诊断冠心病并心力衰竭的价值进行分析。结果研究组患者的HRV指标(SDANN、SDNN、r MSSD)均明显低于对照组(p<0.05),心率则明显高于对照组(p<0.05),而研究组患者的血清Cys-C水平也明显高于对照组(p<0.05);本研究中70例冠心病合并心力衰竭患者均经临床冠脉造影最终确诊。患者单独经动态心电图HRV的正确诊断53例,假阴性17例,诊断敏感度为75.71%;患者单独血清Cys-C水平检测诊断后正确诊断38例,假阴性32例,诊断敏感度为54.39%;当采用HRV联合Cys-C水平检测诊断的正确诊断64例,假阴性6例,诊断敏感度为91.43%。经过统计学分析,差异存在统计学意义(p<0.05)。结论采用动态心电图HRV与Cys-C水平联合检测可有效提高冠心病合并心力衰竭的临床诊断准确性,具有安全、简单、检出率高等优点,具有重要的临床诊断价值。

Objective The purpose of this study was to investigate the clinical diagnostic value of heart rate variability(HRV)parameters combined with Cys-C levels in coronary heart disease and heart failure.Methods A total of 70 patients with coronary heart disease and heart failure admitted to our hospital from March 2016 to March 2018 were recruited as the study group.During the same period,70 healthy volunteers were collected from the outpatient department as the control group.All patients underwent dynamic electrocardiogram examination and serum Cys-C level detection,compared ECG and Cys-C levels between the two groups,and analyzed the diagnostic value of combined detection of both in coronary heart disease and heart failure.Results The HRV parameters(SDANN,SDNN,r MSSD)in the study group were significantly lower than those in the control group(p<0.05),and the heart rate was significantly higher than that in the control group(p<0.05).The serum Cys-C levels in the study group were also significantly higher than those in the control group(p<0.05).In this study,70 patients with coronary heart disease and heart failure were finally diagnosed by clinical coronary angiography.The diagnosis of 53 patients was diagnosed by HRV parameters alone,and 17 cases were false negative.The diagnostic sensitivity was 75.71%.The serum Cys-C level was diagnosed correctly in 38 patients after diagnosis,and 32 cases were false negative.The diagnostic sensitivity was 54.39%.The patient was diagnosed correctly by HRV parameters combined with Cys-C level diagnosis and 64 cases were diagnosed correctly.There were 6 false-negative cases and the diagnostic sensitivity was 91.43%.After statistical analysis,the difference was statistically significant(p<0.05).Conclusions The combined use of HRV parameters and Cys-C level detection can effectively improve the diagnostic accuracy of coronary heart disease and heart failure.It has the advantages of safety,simplicity,high detection rate,and has important clinical diagnostic value.