24h动态心电图联合心肌损伤标志物放射性心肌损伤的检出情况

Analysis of detection of radioactive myocardial injury by 24h dynamic electrocardiogram combined with myocardial injury markers

目的 分析24h动态心电图联合心肌损伤标志物在放射性心肌损伤中的检出情况。方法 选取2021年5月~2023年5月于我院实施放疗的胸部肿瘤患者96例,分别于放疗前、放疗结束后进行24h动态心电图检查、心肌损伤标志物[心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CKMB)]水平检测。比较患者24h动态心电图、心肌损伤标志物及二者联合检查放射性心肌损伤的检出率,分析放疗结束后患者24h动态心电图异常情况;比较放疗前、放疗结束后患者cTnⅠ、CKMB水平。结果 放疗结束后24h动态心电图联合心肌损伤标志物对放射性心肌损伤检出率高于二者独立检查检出率(P<0.05);相较于放疗前,放疗结束后患者24h动态心电图检查中心律异常、房室传导阻滞、束支传导阻滞、ST-T改变发生率均显著升高(P<0.05);放疗结束后,患者cTnⅠ、CKMB水平显著高于放疗前(P<0.05)。结论 24h动态心电图联合心肌损伤标志物在放射新心肌损伤中具有较高检出率,为早期诊断放射性心肌损伤提供依据。

Objective:To analyze the detection of radioactive myocardial injury by 24h dynamic electrocardiogram com⁃bined with myocardial injury markers.Methods:96 patients with thoracic tumors who received radiotherapy in our hospi⁃tal from May 2021 to May 2023 were selected.24h dynamic electrocardiogram(ECG)examination and myocardial injury marker detection[cardiac troponinⅠ(cTnⅠ),creatine kinase isoenzyme(CKMB)]were performed before radiotherapy and after the end of radiotherapy respectively.The detection rate of radioactive myocardial injury by 24h dynamic electro⁃cardiogram,myocardial injury markers,and their combination was compared,and the abnormal condition of 24h dynamic electrocardiogram after the end of radiotherapy was analyzed.The levels of cTnⅠand CKMB were compared before radio⁃therapy and after the end of radiotherapy.Results:After the end of radiotherapy,the detection rate of radioactive myocar⁃dial injury by 24h dynamic electrocardiogram combined with myocardial injury markers was higher than that of the two in⁃dependent tests(P<0.05).After the end of radiotherapy,the incidence rates of heart rate abnormality,atrioventricular block,bundle branch block,and ST-T changes in 24h dynamic electrocardiogram examination were significantly in⁃creased compared to before radiotherapy(P<0.05).The levels of cTnⅠand CKMB after the end of radiotherapy were sig⁃nificantly higher than those before radiotherapy(P<0.05).Conclusion:24h dynamic electrocardiogram combined with myocardial injury markers has a high detection rate of radioactive myocardial injury,and it provides a basis for early diag⁃nosis of radioactive myocardial injury.