24 h动态心电图联合CyPA检测在高血压性心脏病诊断中的应用

Application of 24 h dynamic electrocardiogram combined with CyPA detection in diagnosis of hypertensive heart disease

目的:探讨24 h动态心电图联合亲环素A(CyPA)检测对高血压性心脏病(HHD)的诊断价值。方法:80例HHD患者设为HHD组,另选取同期年龄、性别相匹配且排除心脏损伤的80例高血压患者作为对照组,均行24 h动态心电图检查,并检测血清CyPA水平;比较两组动态心电图ST-T改变阳性率和血清CyPA水平,并应用受试者工作特征曲线(ROC)评价两种检查及其联合对HHD的诊断效能。结果:HHD组ST-T改变阳性率、CyPA水平、CyPA阳性率均高于对照组[83.54%vs.11.25%、(8.15±1.37 ng/L)vs.(10.49±2.06 ng/L)、80.00%vs.16.25%,P<0.05]。24 h动态心电图联合血清CyPA诊断HHD的敏感度为93.75%,特异度为87.50%,ROC曲线下面积(AUC)为0.906,诊断效能优于各单一检查。结论:24 h动态心电图、血清CyPA检测联合应用可提高对HHD诊断的敏感度。

Objective:To investigate the diagnostic value of 24 h dynamic electrocardiogram combined with cyclophilin A(CyPA)in hypertensive heart disease(HHD).Methods:A total of 80 patients with HHD were selected,and another 80 patients with hypertension matched in age and gender and excluded from heart injury at the same period were selected as the control group.All patients underwent 24-hour ambulatory ECG examination and the serum CyPA level was detected.The positive rate of dynamic electrocardiogram ST-T change and serum CyPA level were compared between the two groups,and the diagnostic efficiency of the two examinations and their combination for HHD was evaluated by receiver operating characteristic curve(ROC).Results:The positive rate of ST-T change,CyPA level and CyPA positive rate in HHD group were 83.54%,8.15±1.37 ng/L and 80.00%,respectively,which were significantly higher than 11.25%,10.49±2.06 ng/L and 16.25%in control group(P<0.05).The sensitivity of 24 h ambulatory electrocardiogram combined with serum CyPA in the diagnosis of HHD was 93.75%,the specificity was 87.50%,and the area under ROC curve was 0.906.The diagnostic efficacy was better than that of each single examination.Conclusion:The combined application of 24h dynamic electrocardiogram and serum CyPA detection can improve the sensitivity of HHD diagnosis.