心肌超声造影及心电图联合血清胱抑素C诊断冠心病的价值

Analysis of the value of myocardial contrast echocardiography,electrocardiogram,serum cystatin C and their combination in the diagnosis of coronary heart disease

目的分析心肌超声造影、心电图及血清胱抑素C(CysC)联合诊断冠心病的临床价值。方法选取2018年4月至2021年4月河北医科大学第二医院因胸痛住院的200例患者作为研究对象。所有患者均在入院后进行冠状动脉造影检查并依据其结果分为冠心病组(n=120)与非冠心病组(n=80),依据冠状动脉狭窄程度分为轻度组(n=40)、中度组(n=63)及重度组(n=17),另纳入同期在本院进行体检的健康体检者作为对照组(n=50)。三组患者均行心肌超声造影、心电图及血清CysC检查,分析心肌超声造影、心电图及血清CysC联合诊断冠心病的临床价值。结果冠心病组QTC间期、QRS波时限及血清CysC水平高于非冠心病组及对照组(P<0.05),A值、β值、A×β值低于非冠心病组及对照组(P<0.05)。重度组QTC间期、QRS波时限及血清CysC水平高于中度组及轻度组(P<0.05),A值、β值、A×β值低于中度组及轻度组(P<0.05)。经点二列相关性分析显示,QTC间期、QRS波时限及血清CysC与冠心病冠状动脉狭窄程度呈正相关(P<0.05),A值、β值、A×β值与冠心病患者冠状动脉狭窄程度呈负相关(P<0.05)。绘制受试者工作特征曲线(ROC)结果显示,心肌超声造影、心电图、血清CysC及联合对冠心病均有一定的诊断效能,且以联合诊断效果最佳。结论心肌超声造影、心电图及血清CysC联合诊断冠心病的效能较好,且心肌超声造影、心电图及血清CysC可反映冠心病患者冠状动脉狭窄严重程度。

Objective To analyze the clinical value of myocardial contrast echocardiography,electrocardiogram,serum cystatin C(CysC)and their combination in the diagnosis of coronary heart disease.Methods 200 patients hospitalized with chest pain from April 2018 to April 2021 were selected.All patients underwent coronary angiography after admission and were divided into the coronary heart disease group(n=120)and the non-coronary heart disease group(n=80)based on their results.The coronary heart diseasegroup was divided into the mild group(n=40),moderate group(n=63)and severe group(n=17)according to the degree of coronary artery stenosis.In addition,50 healthy people who underwent physical examination in our hospital at the same time were included as the control group.All patients underwent myocardial contrast echocardiography,electrocardiogram and serum CysC examination and the results were analyzed.Results The QTC interval,QRS wave duration and serum CysC levels in thecoronary heart disease group were higher than those in the non-coronary heart disease group and the control group,and the A value,βvalue and A×βvalue were lower than those in the non-coronary heart disease group and the control group,with a statistically significant difference(P<0.05).Among patients with coronary heart disease,the QTC interval,QRS wave duration and serum CysC levels in the severe group were higher than those in the moderate group and the mild group,while the A value,βvalue and A×βvalue were lower than those in the moderate group and the mild group,with a statistically significant difference(P<0.05).According to the point-biserial correlation,the QTC interval,QRS duration and serum CysC were positively correlated with the degree of coronary artery stenosis in coronary heart disease patients(r>0,P<0.05),while the A value,βvalue and A×βvalue were negatively correlated with the degree of coronary artery stenosis in coronary heart disease patients(r<0,P<0.05).The receiver operating characteristic curve(ROC)was drawn,which showed that myocardial contrast echocardiography,electrocardiogram,serum CysC and their combination had certain diagnostic efficacy for coronary heart disease,and the combined diagnosis had the best effect.Conclusion The combined diagnosis of myocardial contrast echocardiography,electrocardiogram and serum CysC is more effective in the diagnosis of coronary heart disease,and myocardial contrast echocardiography,electrocardiogram and serum CysC can reflect the severity of coronary artery stenosis in coronary heart disease patients.