|
|
Prognostic value of electrocardiogram T wave changes combined with ser-um homocysteine in patients with myocardial infarction after percutaneous coronary intervention |
JIN Mengxue ZHANG Qian▲ |
Department of Functional Examination, Suzhou Hospital of Integrated of Traditional and Western Medicine, Jiangsu Province, Suzhou 215101, China |
|
|
Abstract Objective To explore the prognostic value of electrocardiogram T-wave changes combined with serum homocysteine (Hcy) in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI). Methods A total of 76 MI patients admitted to Suzhou Hospital of Integrated and Western Medicine from January 2017 to July 2022 were selected for PCI. According to the occurrence of major adverse cardiovascular events (MACE) within one year after surgery, they were divided into good prognosis group and poor prognosis group. The general data, electrocardiogram T-wave changes and serum Hcy levels of MI patients in the two groups were compared to analyze the factors affecting the prognosis of MI patients after PCI, and the receiver operating characteristic (ROC) curve was used to analyze the value of electrocardiogram T-wave changes combined with serum Hcy in evaluating the prognosis of MI patients after PCI. Results In 76 MI patients who underwent PCI, a total of 54 patients did not develop MACE and 22 patients developed MACE within one year after surgery. The proportion of T wave inversion and serum Hcy level in the poor prognosis group were higher than those in the good prognosis group, and the differences were statistically significant (P<0.05). Logistic regression analysis showed that serum Hcy level and T wave inversion were independent risk factors for poor prognosis of MI patients after PCI (OR>1,P<0.05). ROC curve analysis showed that the AUC value of Hcy level and T-wave inversion in assessing the prognosis of MI patients after PCI was 0.773 (95%CI: 0.662-0.861) and 0.771 (95%CI: 0.660-0.860), respectively, and the AUC value predicted by the combination of the two was 0.904 (95%CI: 0.815-0.960). Conclusion The changes of electrocardiogram T wave and serum Hcy level have certain predictive value for the prognosis of MI patients after PCI, and the combined value is higher.
|
|
|
|
|
[1] 姜冲,董晓茜,李雨鹏,等.碎裂QRS波与心率变异性及心率减速力对陈旧性心肌梗死的预后评估[J].西部医学,2022,34(7):1050-1055. [2] 刘铁红,董琳琳,高阿妮,等.血清Furin、Nesfatin-1水平与急性ST段抬高型心肌梗死预后的关系[J].东南大学学报(医学版),2022,41(2):260-265. [3] 盛建龙,何非,王敏,等.经皮冠状动脉介入治疗术后炎症指标对急性冠状动脉综合征患者预后的影响[J].中国心血管病研究,2020,18(7):605-610. [4] 梁吉斌,徐宏勇.血清PCT、D二聚体及BNP在急性心肌梗死患者PCI后心功能及预后的临床价值[J].血栓与止血学,2022,28(1):59-61. [5] 李婷,苏晓灵.心电图联合血清cTnI、H-FABP和NT- proBNP对早期急性心肌梗死的诊断价值[J].河北医药,2020,42(5):702-705. [6] 徐志伟,刘茜茜.心电图T波变化情况、血浆N-proBNP水平和Gensini评分对心肌梗死患者预后的预测及各指标的相关性分析[J].影像科学与光化学,2020,38(3):520- 524. [7] 骆金轮,吴非,张登洪,等.血清Hcy、cTnT、甲状腺激素水平对急性心肌梗死病情严重程度及预后评估的价值[J].中国实验诊断学,2021,25(4):490-493. [8] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,《中国循环杂志》编辑委员会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725. [9] 中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400. [10] 朱靖,陈少源,王玉,等.ST段抬高型心肌梗死患者术后发生主要不良心血管事件风险标志物探索[J].中华老年心脑血管病杂志,2022,24(2):140-143. [11] 任艳琴,赵凯华,高胜利,等.降钙素原联合N末端脑钠肽前体预测急性ST段抬高型心肌梗死PCI术病人预后的临床价值[J].中西医结合心脑血管病杂志,2021, 19(8):1349-1352. [12] 杨金月,紫晓,李华丽,等.BNP、Mb及CK?MB水平与急性心肌梗死急诊PCI术后左室重塑及近期预后的相关性[J].分子诊断与治疗杂志,2022,14(11):1905-1908, 1913. [13] 杨芳.老年冠心病患者并发心律失常的临床特征及影响因素[J].中国老年学杂志,2020,40(3):466-468. [14] 闫杰松,周栋,汤祥瑞,等.心电图aVRT波形态与ST段抬高型心肌梗死患者冠状动脉病变程度的关系[J].中国医药导报,2020,17(8):76-79. [15] 单和英,王琴,陈国英.aVR导联T波形态在预测三支病变NSTEMI患者冠状动脉病变程度、心功能及预后中的意义[J].浙江医学,2021,43(22):2437-2440. [16] 杨蓉,胡峥,刘栋,等.急性心肌梗死患者PCI术后心室重构患者血清Hcy、CysC、MMP-1、NGAL的表达及临床意义[J].现代生物医学进展,2021,21(18):3524-3528. [17] 李富利,赵艳军,于健,等.血浆Hcy、BNP、CK-MB联合检测在急性冠脉综合征患者预后评价中的价值[J].河北医药,2021,43(3):394-396,400. [18] 项顺阳,陈文专.GDF-15、Hcy、UA、血小板活化指标及VEGF亚型与急性心肌梗死危险程度的关系探究[J].中国医学创新,2022,19(10):139-142. [19] 王聪.急性ST段抬高型心肌梗死患者术前心电图终末部T波倒置的影响因素及其和预后的关系[D].大连:大连医科大学,2020. [20] 林雪涨.血清同型半胱氨酸、胱抑素C、脂蛋白a及高敏C反应蛋白检测对急性心肌梗死的早期诊断价值[J].中国当代医药,2023,30(2):171-174. [21] 翁巧琳,王英.心电图T波改变、N末端脑钠肽前体水平及Gensini评分在评估心肌梗死患者冠状动脉病变严重程度中的价值研究[J].浙江医学,2022,44(5):493-496,501. [22] 陈文,舒雯君,莫秀丽,等.急性心肌梗死患者SYNTAX评分与血清N-末端脑钠肽前体、同型半胱氨酸及预后关系[J].中国医师进修杂志,2020,43(7):643-650. [23] 杨蓉,但慧敏,孙家安,等.血清同型半胱氨酸水平对急性ST段抬高型心肌梗死PCI术后患者左心室重构、心肌灌注和预后的影响[J].现代生物医学进展,2021,21(11):2148-2152. [24] 林震华,何法剑,范桂晶.急性STEMI患者经皮冠状动脉介入术后24h内心力衰竭的发生状况及影响因素分析[J].中外医学研究,2022,20(31):164-167. [25] 张彦燕,何丽,黄梅,等.红景天苷抑制Hcy诱导的血管内皮细胞氧化应激损伤的实验研究[J].西南民族大学学报(自然科学版),2020,46(4):349-353. [26] 张静,苗鹏飞,史志明,等.血清Gal-3、Hcy与急性心肌梗死患者心力衰竭程度及预后的相关性[J].中南医学科学杂志,2022,50(6):865-868. |
|
|
|