血清果蝇母性DPP同源物2、3与冠状动脉粥样硬化性心脏病患者心脏猝死的相关性

Correlation Analysis of Serum Small Mother Against Decapentaplegic 2,3 and Sudden Cardiac Death in Patients with Coronary Heart Disease

目的 分析血清果蝇母性DPP同源物(serum small mother against decapentaplegic,Smad)2、Smad3与冠状动脉粥样硬化性心脏病(冠心病)患者心脏猝死的相关性。方法 选取2018年3月至2020年6月无锡市人民医院收治的住院接受治疗的冠心病患者134例为研究对象,随访1年,根据冠心病患者有无发生心脏猝死分为猝死组(21例)和未猝死组(113例)。采用酶联免疫吸附试验(ELISA)法检测患者血清中Smad2、Smad3浓度。采用动态心电图仪详细记录患者QT间期、PR间期、QRS波持续时间。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价QRS波持续时间联合Smad2、Smad3对冠心病患者心脏猝死的诊断价值。应用二元Logistic回归分析对影响冠心病患者心脏猝死的危险因素进行分析。结果 与未猝死组相比,猝死组患者QRS波持续时间[(116.74±14.58)ms vs.(88.42±10.67)ms]、血清Smad2[(286.42±38.71)μg/L vs.(164.93±22.28)μg/L]、Smad3[(335.18±50.06)μg/L vs.(190.25±29.72)μg/L]浓度较高,差异有统计学意义(P<0.05)。ROC分析显示,QRS波持续时间、血清Smad2和Smad3浓度诊断冠心病患者心脏猝死的曲线下面积(area under the curve,AUC)分别为0.742、0.825、0.842;QRS波持续时间联合Smad2、Smad3诊断冠心病患者心脏猝死的AUC为0.893,其敏感度、特异度分别为81.00%、93.80%。QRS波持续时间、Smad2、Smad3是冠心病患者心脏猝死危险因素(P<0.05)。结论 动态心电图联合血清Smad2、Smad3浓度检测对预测冠心病患者心脏猝死有一定价值。

Objectives To analyze the correlations between serum small mother against decapentaplegic(Smad)2,Smad3 and sudden cardiac death in patients with coronary heart disease.Methods During March 2018 to June 2020,134 patients with coronary heart disease who hospitalized in Wuxi Peoples Hospital were selected as the research objects.The patients were followed up for 1 year and divided into the sudden death group(21 cases)and non-sudden death group(113 cases)according to whether there was sudden cardiac death.The serum concentrations of Smad2 and Smad3 were detected by enzyme-linked immunosorbent assay(ELISA).A dynamic electrocardiogram was used to record the QT interval,PR interval,and QRS wave duration in detail.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of QRS wave duration combined with Smad2 and Smad3 in the diagnosis of sudden cardiac death in patients with coronary heart disease.Binary Logistic regression was used to analyze the risk factors of sudden cardiac death in patients with coronary heart disease.Results Compared with the non-sudden death group,the QRS wave duration[(116.74±14.58)ms vs.(88.42±10.67)ms],serum concentrations of Smad2[(286.42±38.71)μg/L vs.(164.93±22.28)μg/L],and Smad3[(335.18±50.06)μg/L vs.(190.25±29.72)μg/L]were significantly higher in sud-den death group(P<0.05).The ROC result showed that the area under the curve(AUC)of QRS wave duration,serum concentrations of Smad2 and Smad3 for diagnosis of sudden cardiac death in patients with coronary heart disease was 0.742,0.825 and 0.842,respectively;the AUC of QRS wave duration combined with Smad2 and Smad3 for the diagnosis of sudden cardiac death in patients with coronary heart disease was 0.893,and the sensitivity and specificity were 81.00%and 93.80%,respectively.QRS wave duration,Smad2 and Smad3 were risk factors for sudden cardiac death in patients with coronary heart disease(P<0.05).Conclusions Dynamic electrocardiogram combined with serum Smad2 and Smad3 detection has certain value in predicting sudden cardiac death in patients with coronary heart disease.