急性失血性贫血对患者心电图及肌钙蛋白Ⅰ的作用

Cross-sectional study: the effect of acute hemorrhagic anemia on the electrocardiogram and troponin Ⅰ in patients

目的:通过分析急性失血性贫血对患者心电图12导联变化及心肌损伤的作用,为临床进一步心电图鉴别及干预提供参考。方法:参考贫血标准调阅我院2018年6月—7月的急性失血性贫血住院患者,完成心电图检查者106例(观察组),同期入院无贫血患者完成心电图检查103例(对照组)。比较2组患者肌钙蛋白I水平,同时分析各导联心电图改变情况。结果:观察组肌钙蛋白-I[(0.026 4±0.103 8)μg/L]显著高于对照组[(0.000 6±0.004 0)μg/L,P<0.05]。观察组患者心电图AVF[(-0.009 2±0.242 3) m V)]、V4[(-0.012 7±0.032 2) m V]、V5[(-0.017 0±0.032 1) m V]及V6[(-0.016 8±0.031 6) m V]导联ST段压低值均高于对照组[AVF (-0.000 5±0.005 0)、V4(-0.003 4±0.016 1)、V5(-0.006 4±0.024 0)及V6(-0.007 4±0.024 8) m V,均P<0.01]。急性失血性贫血患者的年龄、红细胞、血小板、血糖、总胆固醇、三酰甘油及心率与肌钙蛋白I的含量之间存在线性相关(均P<0.05)。结论:急性失血性贫血可引起心电图AVF、V4、V5及V6导联ST段压低,同时观察组肌钙蛋白I升高,提示贫血对心电图、心肌损伤标志物可能有影响。

Objective To analyze the relationship between acute hemorrhagic anemia and the changes in 12 electrocardiogram (ECG) and the myocardial injury.Methods The medical records of this study were randomly chosen from Shanghai Sixth People’s Hospital.A total of 209 patients who received ECG examination during June 2018 to July 2018 were included in the study.Among them,103 patients with acute hemorrhagic anemia were taken as the observation group,and 106 patients without anemia were taken as the control group.We did retrospective analysis about the demographic characteristics/profiles and compared the ECG changes between the two groups.Results The demographic characteristics:troponin I (Tn-I) of the observation group[(0.026 4±0.103 8)μg/L]was significantly higher than that of the control group[(0.000 6±0.004 0)μg/L,P<0.05].The ST segment changes of each lead in ECG:the ST segment depression values of AVF[(-0.009 2±0242 3) m V)]、V4[(-0.012 7±0.032 2) m V]、V5[(-0.017 0±0.032 1) m V]and V6[(-0.016 8±0.031 6) m V]leads in the observation group were higher than those in the control group[AVF (-0.000 5±0.005 0) m V、V4(-0.003 4±0.016 1)、V5(-0.006 4±0.024 0)、V6(-0.007 4±0.024 8) m V,P<0.01].There were linear corrolations between troponin I and age,erythrocyte and platelet counts,blood glucose,total cholesterol,triglyceride levels as well as heart rate in patients with acute blood loss (P<0.05).Conclusions Acute hemorrhagic anemia is one of the causes leading to AVF,V4,V5and V6ST segment depression I in ECG.At the same time,the elevated troponin I in the observation group suggested that anemia might affect ECG and the markers of myocardial injury.