非ST抬高型ACS患者窦性心律震荡与ST-T及超敏肌钙蛋白关系分析

Relationship analysis of sinus rhythm turbulence and ST-t and high-sensitivity troponin of patients with Non-ST elevation ACS

目的探讨非ST抬高型急性冠状动脉综合征(acute coronary syndrome,ACS)患者窦性心律震荡与ST-T及超敏肌钙蛋白关系分析。方法回顾性分析2014年9月~2016年5月期间我院及广东省人民医院确诊治疗的非ST抬高型ACS患者62例,依据是否伴有窦性心律震荡异常分为异常组(n=28例)和正常组(n=34例),所有患者均给予经心脏彩超、动态心电图等检查,采用酶联免疫吸附法检测血清超敏肌钙蛋白T(hypersensitive troponin T,hs-TnT)水平,采用Pearson相关性分析法分析震荡初始值(turbulence onset,TO)、震荡斜率(turbulence slope,TS)水平与ST-T压低、血清hs-TnT水平的关系。结果异常组患者TO、ST-T压低、血清hs-TnT水平明显高于正常组,前者TS水平明显低于后者,差异有统计学意义(P<0.05);Pearson相关性分析法结果显示,TO水平与ST-T压低、血清hs-TnT水平呈正相关(r_1=0.731,P<0.05;r_2=0.702,P<0.05),TS水平与ST-T压低、血清hs-TnT水平呈负相关(r_3=-0.714,P<0.05;r_4=-0.685,P<0.05)。结论非ST抬高型ACS患者窦性心律震荡中的TO、TS水平与ST-T压低及血清hs-TnT水平有关,提示其也具有有效反映患者病情的作用,可作为患者病情新的心电评估指标之一,值得临床作进一步推广。

Objective To explore relationship analysis of sinus rhythm turbulence and ST-t and high-sensitivitytroponin of patients with non-ST elevation acute coronary syndrome(ACS).Methods62patients with Non-STElevation ACS who were diagnosed and treated in our hospital and Guangdong General Hospital from September2014to May2016were retrospectively analyzed.According to sinus rhythm turbulence abnormality,all patients were dividedinto the abnormal group(n=28)and the normal group(n=34).All patients were given heart color ultrasound,dynamicelectrocardiogram and other examinations.Hypersensitive troponin T(hs-TnT)level was detected by enzyme-linkedimmunosorbent assay.Relationship between turbulence onset(TO)and turbulence slope(TS)and ST–T lowering andserum hs-TnT level was analyzed by Pearson correlation analysis.Results TO,ST-t lowering and serum hs-TnT levelsof patients in the abnormal group were significantly higher than those of the normal group while TS was significantly lowerthan that of the normal group.There were statistical differences(P<0.05).Results of Pearson correlation analysis showedTO level,ST–T lowering and serum hs-TnT level were positively correlated(r1=0.731,P<0.05;r2=0.702,P<0.05).TS level,ST–T lowering and serum hs-TnT level werenegatively correlated(r3=0.714,P<0.05;r4=0.685,P<0.05).Conclusion For patients with non-ST elevation acute coronary syndrome,TO level and TS level are correlated toST–T lowering and serum hs-TnT level.It indicates its effect of effectively reflecting diseases of patients and it canbe regarded as the new ECG evaluation index,which is worthy of further clinical promotion.