新型冠状病毒肺炎孕妇心电图改变与心肌损伤的相关性研究

Correlation Study between ECG Changes and Myocardial Injury in Pregnant Women with COVID-19

目的分析新型冠状病毒肺炎(COVID-19)孕妇心电图变化和心肌损伤的关系。方法回顾性分析本院收治COVID-19孕妇总共198例的临床资料,依据心电图有无异常改变情况分成异常改变组和正常组,观察两组一般资料以及心肌损伤标志物水平,并比较不同病情严重度COVID-19孕妇的心电图异常率以及心肌损伤标志物水平,分析COVID-19孕妇心电图变化和心肌损伤之间的关系。结果198例COVID-19孕妇中,心电图正常158例,占比79.80%;心电图异常40例,占比20.20%,心电图异常变化类型主要包含传导阻滞、过早搏动、ST段压低、ST段斜上和弓背向上抬高、左室导联有关T波低平、病理性Q波、Wellens波以及低电压等,占比分别为1.52%、1.52%、2.02%、5.05%、6.06%、2.02%、1.01%、1.01%。异常改变组的血清肌钙蛋白I、肌红蛋白以及肌酸激酶同工酶水平高于正常组(P<0.05)。不同病情严重度COVID-19孕妇的心电图异常率及心肌损伤标志物水平相比差异显著(P<0.05),普通型组的心电图异常率及各项心肌损伤标志物水平高于轻型组(P<0.05),重型或者危重型组的心电图异常率及各项心肌损伤标志物水平高于普通型组(P<0.05)。相关性分析显示,COVID-19孕妇心电图异常改变率和肌钙蛋白I、肌红蛋白、肌酸激酶同工酶水平之间均为正相关关系(r=0.785、0.814、0.790,P<0.05)。结论COVID-19孕妇心电图变化和心肌损伤有关,心电图异常改变常提示心肌损伤,需要尽早识别出心电图异常并开展个体化干预。

Objective To analyze the relationship between electrocardiogram changes and myocardial injury in pregnant women with COVID-19(COVID-19).Methods The clinical data of 198 cases of COVID-19 in our hospital were divided into abnormal change groups and normal groups,observed two groups of general data and the level of myocardial injury markers,compared the rate of COVID-19,and analyzed the relationship between ECG changes and myocardial injury in COVID-19 pregnant women.Results Among 198 pregnant women with COVID-19,158 patients had normal ECG,accounting for 79.80%;40 patients had abnormal ECG,accounting for 20.20%,mainly including the types of abnormal ECG changesblock,premature beat,the depressed ST segment,the ST segment being oblique and dorback raised upward,LV leads concerning T-wave low ping,Pathology Q wave,Wellens Wave and low voltage accounted for 1.52%,1.52%,2.02%,5.05%,6.06%,2.02%,1.01%,1.01%,respectively.Serum troponin I,myoglobin,and creatine kinase isoenzyme levels were higher in the abnormal change group than in the normal group(P<0.05).The rate of ECG abnormality and the level of myocardial injury markers in pregnant women with COVID-19 were significantly(P<0.05),and the ECG abnormality rate and the level of myocardial injury markers were higher than thatlight-dutyGroup(P<0.05),Severe or critical type groupECG abnormality rate and various,the level of myocardial injury markers is higher thanOrdinary type group(P<0.05).Correlation analysis showed a positive correlation between the levels of abnormal ECG changes in pregnant women and troponin I,myoglobin and creatine kinase in COVID-19(r=0.785,0.814,0.790,P<0.05).Conclusion Electrocardiographic changes in COVID-19 pregnant women are related to myocardial injury.The electrocardiogram abnormal changes often indicate myocardial injury,so it is necessary to identify electrocardiogram abnormalities as soon as possible and carry out individualized intervention.