冠心病心律失常的危险因素及cTnI、NT-proBNP、MMP-9的预测价值

Risk factors for the development of arrhythmia and the predictive value of cTnI,NT-proBNP,and MMP-9 in sinus arrhythmia

目的:探讨冠心病患者发生心律失常的危险因素及心肌肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)对心律失常的预测价值。方法:选取110例冠心病治疗后发生心律失常的患者作为心率失常组;选取同期150例冠心病治疗后心律正常患者作为无心律失常组。对冠心病患者心律失常发生相关变量进行单因素、多因素Logistic回归分析。分析cTnI、NT-proBNP、MMP-9指标水平对心律失常的预测价值。结果:单因素分析显示,两组患者年龄、体质量、纽约心脏病协会(NYHA)分级、吸烟史、合并糖尿病、病变部位、合并慢性阻塞性肺疾病(COPD)、cTnI、NT-proBNP、MMP-9均有统计学差异(P<0.05)。多因素Logistic回归分析显示,年龄≥60岁、体质量≥60 kg、NYHA分级Ⅲ~Ⅳ级、存在吸烟史、合并糖尿病、右冠状动脉、合并COPD、cTnI≥4.50μg/L、NT-proBNP≥280 ng/L、MMP-9≥180μg/L均是影响冠心病患者发生心律失常的主要危险因素。ROC曲线显示,联合检测预测心律失常诊断效能高于cTnI、NT-proBNP、MMP-9单一检测。结论:cTnI、NT-proBNP、MMP-9是影响冠心病患者发生心律失常的主要关键性危险因素,三者对心律失常均具有较好的预测价值。

Objective:The risk factors for arrhythmia in CAD patients and the predictive value of cardiac troponin I(cTnI),N-terminal B brain minatriuretic peptide precursor(NT-proBNP)and matrix metalloproteinase-9(MMP-9)for sinus arrhythmia.Methods:110 patients experienced arrhythmia after coronary heart disease treatment were selected as the arrhythmia group,and 150 patients with normal heart rhythm after coronary heart disease treatment during the same period as the group without arrhythmia.Univariate and multivariate Logistic regression analysis of the variables related to arrhythmia occurrence in patients with CAD.The predictive value of cTnI,NT-proBNP,and MMP-9 index levels for arrhythmia was analyzed.Results:Univariate analysis showed that age,weight,NYHA grade,smoking history,diabetes mellitus,lesion site,COPD,cTnI,NT-proBNP,and MMP-9 were statistically different in patients with coronary heart disease(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years,weight≥60kg,NYHAⅢ~Ⅳgrade,history of smoking,presence of complicated diabetes,right coronary artery,presence of COPD,cTnI≥4.50μg/L,NT-proBNP≥280 ng/L,and MMP-9≥180μg/L were the main risk factors affecting arrhythmia in CAD patients.The ROC curve showed that the efficacy of the combined test in predicting arrhythmia diagnosis was higher than the single cTnI,NT-proBNP,and MMP-9 test.Conclusion:The cTnI,NT-proBNP,and MMP-9 are the main key risk factors affecting the development of arrhythmia in CAD patients.Analysis of cTnI,NT-proBNP,and MMP-9 had a good predictive value for arrhythmia.