心尖肥厚型心肌病患者心电图检查情况与血浆内皮素-1水平变化的关系

Relationship between electrocardiogram and plasma endothelin-1 in patients with apical hypertrophic cardiomyopathy

目的探讨心尖肥厚型心肌病患者心电图检查情况与血浆内皮素-1水平变化的关系。方法回顾性选取2019年4月到2021年4月榆林市第一医院收治的共90例心尖肥厚型心肌病患者作为研究对象,并将其分为观察组,另取同期90名健康体检者作为对照组。对比两组受检者的心电图检查情况,分析观察组患者I、aVL、V_(2)-V_(6)导联的ST下移程度、倒置T波深度和R波振幅分析,对比两组患者I、aVL、V_(2)-V_(6)导联的R波振幅情况,并依照心电图检查将90例心尖肥厚型心肌病患者分为房颤组和窦律组,对比两组患者的一般资料与血浆内皮素-1水平,并进一步分析心电图特点与血浆内皮素-1的相关性。结果90例心尖肥厚型心肌病患者中有87例患者出现心电图异常现象。常规12导联心电图显示,有28例为房颤,62例为窦性心律。心电图检查发现,有87例患者出现巨大倒置T波,有69例患者左胸导联比肢体导联明显下移,有76例患者出现左胸前导联R波增高。观察组患者I、aVL、V_(2)-V_(6)导联的R波振幅均高于对照组,差异均有统计学意义(P<0.05);房颤组(n=28)与窦律组(n=62)患者性别、体重指数、血红蛋白、肌酸激酶同工酶、C反应蛋白、糖化血红蛋白等比较差异无统计学意义(P>0.05),房颤组年龄为(56.29±8.42)岁,小于窦律组[(60.30±10.57)岁],血浆内皮素-1表达量为(0.77±0.72)pmol/L,大于窦律组[(0.58±0.54)pmol/L],差异均有统计学意义(P<0.05)。性别、体重指数、血红蛋白、肌酸激酶同工酶、C反应蛋白、糖化血红蛋白与心尖肥厚型心肌病患者心电图检查情况无明显相关性(P>0.05),年龄、血浆内皮素-1与患者心电图检查情况具有明显相关性(r=0.579、0.478,P<0.05)。结论心尖肥厚型心肌病患者会出现巨大倒置T波、ST段下移与R波振幅现象,与健康者相比心电图明显异常,并且患者的心电图检查结果与血浆内皮素-1具有明显相关性,因此血浆内皮素-1可以考虑作为心尖肥厚型心肌病患者的病情判断的一个参考指标。

Objective To investigate the relationship between ECG and plasma endothelin-1 in patients with apical hypertrophic cardiomyopathy.Methods A total of 90 patients with apical hypertrophic cardiomyopathy who were admitted to the First Hospital of Yulin City from December 2017 to December 2020 were retrospectively selected as the research objects,and they were divided into the observation group,and 90 healthy patients in the same period were selected as the control group.The ECG examination of the two groups were compared,and the ST depression degree,inverted T wave depth and R wave amplitude of lead I,AVL and V_(2)-V_(6) in the observation group were analyzed.According to ECG examination,90 patients with apical hypertrophic cardiomyopathy were divided into atrial fibrillation group and sinus rhythm group.The general data and plasma endothelin-1 levels of the two groups were compared,and the correlation between ECG characteristics and plasma endothelin-1 was further analyzed.Results Among 90 patients with apical hypertrophic cardiomyopathy,87 patients had abnormal ECG,the conventional 12-lead ECG showed that 28 cases had atrial fibrillation and 62 cases had sinus rhythm,76 patients had higher R wave in left precordial lead;the R wave amplitudes of lead I,aVL and V_(2)-V_(6) in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in gender,BMI,hemoglobin,creatine kinase isoenzyme,C-reactive protein and glycosylated hemoglobin between sinus rhythm group(n=28)and atrial fibrillation group(n=62)(P>0.05),the age of atrial fibrillation group was(56.29±8.42)years,which was less than that of sinus rhythm group[(60.30±10.57)years].The expression of plasma endothelin-1 was(0.77±0.72)pmol/L,which was greater than that of sinus rhythm group[(0.58±0.54)pmol/L],and the differences were statistically significant(P<0.05).There was no statistically significant correlation between gender,body mass index,hemoglobin,creatine kinase isoenzyme,C-reactive protein and glycosylated hemoglobin and ECG examination of patients with apical hypertrophic cardiomyopathy(P>0.05),age and plasma endothelin-1 were significantly correlated with ECG(r=0.579,0.478,P<0.05).Conclusion Patients with apical hypertrophic cardiomyopathy will have huge inverted T wave,ST segment down shift and R wave amplitude phenomenon.Compared with healthy people,ECG is obviously abnormal,and the results of ECG examination of patients have obvious correlation with plasma endothelin-1,so plasma endothelin-1 can be considered as a reference index for judging the condition of patients with apical hypertrophic cardiomyopathy.