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| Diagnostic value of serum CD40 ligand and QTc interphase level in postoperative arrhythmia of coronary heart disease |
| ZHANG Qian1 LI Xiaolong2 JIN Mengxue1▲ |
1.Department of Functional Examination, Suzhou Hospital of Integrated Chinese and Western Medicine, Jiangsu Province, Suzhou 215000, China;
2.Department of Internal Medicine, Wuzhong District Mudu Town Community Health Service Center, Jiangsu Province, Suzhou 215000, China |
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Abstract Objective To explore the diagnostic value of serum CD40 ligand (CD40L) combined with QTc interphase level of ambulatory electrocar-diogram in postoperative arrhythmia of coronary heart disease. Methods A total of 89 patients with coronary heart disease admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to January 2022 were selected. Clinical medical records of the patients were collected and collated, and ambulatory electrocar-diogram and CD40L levels were detected after admission. According to the occurrence of arrhythmia within one month after percutaneous coronary intervention, the patients were divided into occurrence group (ten cases) and non-occurrence group (79 cases). Logistic regression model was used to analyze the influencing factors of postoperative arrhythmia, and the diagnostic value of QTc interphase level and serum CD40L level in arrhythmia was further evaluated by receiver operating characteristics (ROC) curve. Results The levels of serum potassium, QTc interphase level, and CD40L in the occurrence group were higher than those in the non-occurrence group, the differences were statistically significant (P＜0.05). Analysis of influencing factors showed that blood potassium (OR=3.684, 95%CI: 1.259-5.685), QTc interval (OR=2.743, 95%CI: 1.259-6.666), and serum CD40L (OR=3.340, 95%CI: 1.374-8.118) were the influential factors for postoperative arrhythmia in patients with coronary heart disease (P＜0.05). ROC curve analysis showed that the combined QTc interphase level of ambulatory electrocar-diogram, and serum CD40L level were more effective in diagnosing arrhythmias than those predicted by them alone (P＜0.05). Conclusion The QTc interphase level of ambulatory electrocar-diogram and serum CD40L are abnormal in patients with post-coronary heart disease arrhythmia, and the levels of serum CD40L combined with QTc interphase level are of high diagnostic value for postoperative arrhythmia of coronary heart disease.
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[1] Ameloot K，Jakkula P，H?覿stbacka J，et al. Optimum Blood Pressure in Patients With Shock After Acute Myocardial Infarction and Cardiac Arrest [J]. J Am Coll Cardiol，2020， 76（7）：812-824.
[2] Vardas P，Cowie M，Dagres N，et al. The electrocardiogram endeavour：from the Holter single-lead recordings to mul- tilead wearable devices supported by computational machine learning algorithms [J]. Europace，2020，22（1）：19-23.
[3] Shen J，Liu G，Yang Y，et al. Prognostic impact of mean heart rate by Holter monitoring on long-term outcome in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention [J]. Clin Res Cardio，2021， 110（9）：1439-1449.
[4] 余彩霞，顾方方.冠心病伴发心律失常的联合预测因子构建与验证[J].广东医学，2021，42（9）：1111-1114.
[5] Teslenko A，Fries RC，Selmic LE. Comparison of in-hospital continuous electrocardiography versus recordable Holter monitoring in dogs with ventricular arrhythmias [J]. J Vet Emerg Crit Care（San Antonio），2021，31（6）：758-765.
[6] 梁伟国，钱梅.冠心病介入术后发生心律失常影响因素分析[J].陕西中医，2021，5（1）：107-108.
[7] 晋群，秦永文，李晓燕，等.冠心病介入治疗前后血清白细胞介素18，可溶性CD40L和超敏C反应蛋白变化与早期并发症的关系[J].中国临床医学，2019，94（6）：785- 787.
[8] Sitorus GDS，Ragab AAY，Houck CA，et al. Ventricular Dysr- hythmias During Long-Term Follow-Up in Patients With In- herited Cardiac Arrhythmia [J]. Am J Cardiol，2019，124（9）：1436-1441.
[9] 沈迎，张奇，沈卫峰.美国和欧洲稳定性冠心病诊治指南解读[J].中华心血管病杂志，2014（1）：70-72.
[10] 彭瑞君，杨希立.急性冠脉综合征PCI术后应用替格瑞洛对血浆和肽素水平的影响及临床意义[J].中国现代医学杂志，2018，28（34）：84-89.
[11] Health Quality Ontario. Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia：A Health Technology Assessment [J]. Ont Health Technol Assess Ser，2017，17（1）：1-56.
[12] Gladding PA，Legget M，Fatkin D，et al. Polygenic Risk Sco- res in Coronary Artery Disease and Atrial Fibrillation [J]. Heart Lung Circ，2020，29（4）：634-640.
[13] Merino-Merino A，Saez-Maleta R，Salgado-Aranda R，et al. Biomarkers in atrial fibrillation and heart failure with non-reduced ejection fraction：Diagnostic application and new cut-off points-ScienceDirect [J]. Heart Lung，2020， 49（4）：388-392.
[14] Gorenek B，Fisher JD，Kudaiberdieva G，et al. Premature ventricular complexes：diagnostic and therapeutic considerations in clinical practice ：A state-of-the-art review by the American College of Cardiology Electrophysiology Council [J]. J Interv Card Electrophysiol，2020，57（1）：5-26.
[15] Lopes RD，Hong H，Harskamp RE，et al. Safety and Efficacy of Antithrombotic Strategies in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention：A Network Meta-analysis of Randomized Controlled Trials [J]. JAMA Cardiol，2019，4（8）：747-755.
[16] Lopes RD，Leonardi S，Wojdyla DM，et al. Stent Thrombosis in Patients With Atrial Fibrillation Undergoing Coronary Stenting in the AUGUSTUS Trial [J]. Circulation，2020，141（9）：781-783.
[17] 甘晓雅.血必净注射液对急性冠脉综合征患者血清sCD40L和Lp-PLA2水平的影响[J].山东医药，2019，54（34）：32-34.
[18] 任丽，王阶，冯玲，等.64层CTA结合血清MMP-9、sCD40L评价冠脉临界病变斑块成分及稳定性[J].心脏杂志，2011，23（6）：790-793.
[19] 侯娜.动态心电图诊断冠心病患者心肌缺血与心律失常的价值[J].实用临床医药杂志，2022，5（10）：11-14.
[20] 于华，梁伟，张官鹏.冠心病患者采用动态心电图诊断的临床意义[J].中国实验诊断学，2019，19（8）：1292-1294.
[21] 吴秀莲.动态心电图对冠心病的诊断价值[J].南方医科大学学报，2021，37（2）：93-95.
[22] 李智群.动态心电图联合CTA对冠心病心肌缺血的诊断价值[J].中国CT和MRI杂志，2021，19（5）：11-13.
[23] 王希娟.平板运动试验联合多导联动态心电图对冠心病的诊断价值[J].现代科学仪器，2021，38（5）：152-156.
[24] 蔡宏华，张美玲，骆小娟.基于12导联动态心电图的ST段联合卵磷脂胆固醇脂酰基转移酶、脂蛋白a对冠心病的诊断价值[J].中国医药科学，2021，11（15）：180-182， 196.
[25] 李燕丽，孙静，陈燕，等.动态心电图结合临床路径评价冠心病伴心律失常的价值[J].影像科学与光化学，2022， 9（4）：316-319.
[26] 姜小琴，苟代文.动态心电图联合增强CT对冠心病心肌缺血的诊断价值研究[J].中国CT和MRI杂志，2022， 8（9）：79-80. |
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