心电图QT离散度与急性脑血管病患者血清酶学变化相关性研究

Correlation between QT dispersion and serum enzyme changes in patients with acute cerebrovascular disease

目的:探讨急性脑血管病患者心电图QT离散度(QT dispersion,QTd)与血清酶学变化相关性及其意义。方法:随机抽取我院2011年2月-2012年1月期间90例急性脑血管病门诊患者为观察组,按1∶1同时征集90例健康者为对照组。所有患者和健康者均接受12导联心电图检查,测量QTd间期值,并计算QTd。采用ELISA试剂盒检测血清天门冬氨酸氨基转移酶(transferase,AST)、乳酸脱氢酶(lactate dehydrogenase,LDH)、α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,α-HBDH)、肌酸激酶(creatine kinase,CK)和心肌型肌酸激酶同功酶(creatine kinase isoenzyme,CK-MB)水平,并分析QTd与血清酶学的相关性。结果:观察组患者血清AST、LDH、α-HBDH和CK平均酶活浓度明显高于对照组(t=10.13,P=0.000;t=12.55,P=0.000;t=13.14,P=0.000;t=20.91,P=0.000),但心肌型CK-MB平均酶活浓度与对照组差异无统计学意义(t=0.88,P=0.378)。观察组患者QTd平均值明显高于对照组(t=9.09,P=0.000)。QTd与血清酶学(AST、LDH、α-HBDH和CK)酶活浓度呈正相关性(r=0.913,P=0.001;r=0.923,P=0.002;r=0.727,P=0.021;r=0.823,P=0.017)。结论:急性脑血管病患者心电图QTd和血清酶学(AST和LDH)酶活浓度两者联合检测在急性脑血管病的诊断中具有一定的临床价值。

Objective：To investigate the correlation between QT dispersion （QTd） and serum enzyme changes in patients with acute cerebrovascular disease and to evaluate the diagnosis value of QTd and serum enzyme changes. Methods： Totally 90 patients with acute cerebrovascular disease from February 2011 to January 2012 were served as observation group;90 healthy subjects from February 2011 to January 2012 were served as control group. All patients and healthy subjects received 12-lead electrocardiogram（ECG） and QTd was measured. Commercial kits were used to measure the activity concentration of transferase（AST）,lactate debydrogenase（LDH）, ot-hydroxybutyrate dehydrogenase（ct-HBDH）,creatine kinase（CK） and myocardial-type creatine kinase isoenzyme（CK-MB）. Corre- lation analysis of QTd and serum enzymes was performed. Results ： Average activity concentrations of serum AST, LDH, α-HBDH and CK of observation group were significantly higher than those of control group （t= 10.13, P=0.000; t= 12.55, P=0.000; t= 13.14, P=0.000; t=20.91,P=0.000）, but average activity concentration of myocardial-type CK-MB has no significant difference between the two groups （t=0.88,P=0.378）. Average QTd of observation group was significantly higher than that of control group（t=9.09,P=O.O00）. QTd and serum enzymes （AST, LDH, α -HBDH and C K） activity were positively correlated （r =0.913, P=O.00 l ; r=0.923, P=0.002; r =0.727, P= 0.021 ;r=0.823 ,P=0.017）. Conclusions：QTd and serum enzyme（AST and LDH） activity concentration combined detection has potential clinical value for diagnosis of acute vascular disease.