阵发性室上速伴肌钙蛋白升高的临床分析

目的部分阵发性室上速(PVST)患者伴随肌钙蛋白(cTn I)水平升高,本研究旨在探讨PVST导致cTnI升高是否与冠脉狭窄程度存在相关性。方法回顾性分析本院2018年至2022年,因PVST急诊入院,后经心脏电生理检查证实,并完成射频消融术的成年患者共224例,其中cTn I水平正常者142例,设为对照组,cTn I水平升高者82例,设为观察组。住院期间均完成冠脉CT或冠脉造影检查。结果观察组室上速发作时心室率较对照组快[(164.8±14.8)VS.(156.6±20.1)],观察组心衰指数、纤溶指数更高,且房室结双径路人数占比更多,两组差异有统计学意义(P<0.05)。但两组冠脉狭窄程度方面差异无统计学意义(P>0.05)。结论室上速发作伴随cTn I水平升高者,若心电图无明显ST-T动态演变或症状上无典型胸痛,cTn I水平升高一般考虑快心室率导致心肌损伤可能性大,与冠脉狭窄不一定存在相关性,临床上应减少误诊为急性冠脉综合征。

Objective To investigate whether increased cTnI induced by PVST is correlated with the degree of coronary stenosis.Methods A total of 224 adult patients admitted to our hospital for emergency treatment with PVST from 2018 to 2022 and confirmed by cardiac electrophysiological examination and completed radiofrequency ablation were retrospectively analyzed.Among them,142 patients with normal troponin were classified as the control group,and 82 patients with elevated troponin were classified as the study group.Coronary CT or coronary angiography were performed during hospitalization.Results The ventricular rate in the study group was faster than that in the control group[(164.8±14.8)VS.(156.6±20.1)].The heart failure index and fibrinolysis index were higher in the study group,and the number of people with dual av node path was more than that in the control group.There were statistical differences between the two groups.However,there was no significant difference in the degree of coronary stenosis between the two groups.Conclusion For supraventricular tachycardia with elevated troponin,if there is no obvious ST-T changes in ECG or typical chest pain in symptoms,elevated troponin is generally related to rapid heart rate which cause myocardial injury.And cTnI is not necessarily correlated with coronary stenosis.Clinically,misdiagnosis as acute coronary syndrome should be reduced.