冠状动脉血管成像联合动态心电图与冠心病冠脉狭窄程度及预后的关联研究

Study on the correlation between Coronary CT angiography combined with dynamic electrocardiogram and the degree and prognosis of coronary stenosis in coronary heart disease

:-
 
目的:分析冠状动脉CT血管成像(CTA)联合动态心电图(DCG)与冠心病患者冠脉狭窄程度及预后情况的关联。方法:研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者,分别列为病例组和对照组,比较两组CTA参数、DCG参数间差异。依据入院测得(Gensini)评分不同,将入组患者分别列为轻度组(60例,Gensini评分≤30分)、中度组(75例,Gensini评分>30分、≤60分)和重度组(75例,Gensini评分>60分),比较三组CTA参数、DCG参数间差异,分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况,比较不同预后患者CTA参数、DCG参数间差异,归纳冠心病患者预后影响因素,检验CTA参数、DCG参数对患者不良预后的预测效能。结果:病例组的最小管腔直径(MLD)、最小管腔面积(MLA)、血流储备分数(FFR)、正常窦性间期的标准差(SDNN)、每5min平均RR间期的标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)均低于对照组,斑块总体积(TPV)、低频/高频比值(LF/HF)均高于对照组(t=24.128,25.811,15.613,37.636,26.858,9.195,59.862,29.389;P<0.05)。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组,轻度组,TPV、LF-HF均高于中度组,轻度组(F=190.291,51.562,186.482,42.084,44.413,22.541,56.503,109.983;P<0.05)。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关,TPV、LF-HF均与Gensini评分正相关(r=-0.352,-0.377,-0.445,-0.472,-0.332,-0.356,0.401,0.355;P<0.05)。经统计,210例冠心病患者的不良预后发生率为38.10%(80/210)。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组,TPV、LF-HF均高于预后良好组(t=6.827,12.219,19.313,6.097,7.097,5.027,7.088,12.465;P<0.05)。MLA、FFR、SDNN升高为冠心病不良预后的保护因素,LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测(Delong检验,P<0.05)。结论:CTA、DCG能客观评估冠心病患者冠脉狭窄程度,联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。
Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128,25.811,15.613,37.636,26.858,9.195,59.862,29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291,51.562,186.482,42.084,44.413,22.541,56.503,109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352,-0.377,-0.445,-0.472,-0.332,-0.356,0.401,0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827,12.219,19.313,6.097,7.097,5.027,7.088,12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05).Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.
论著

经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析

Analysis of the influencing factors of adverse psychological health status in patients with kinesiophobia after percutaneous coronary intervention

:1712-1723
 
       目的   识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果  271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
       Objective  To identify the risk factors associated with depression,anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods  In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results  Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
论著

儿童川崎病冠状动脉损伤危险因素分析

Analysis of risk factors for coronary artery injury in children with Kawasaki disease

:530-534
 
目的 调查儿童川崎病(KD)冠状动脉损伤发生情况,并进行危险因素分析。方法 选择2018年1月—2022年12月在泉州市妇幼保健院儿童医院诊治的KD儿童782例为研究对象,所有患儿在入院时均给予超声检查,判定冠状动脉损伤情况,调查所有患儿的一般资料,进行危险因素分析。结果 782例患儿中,超声判断为冠状动脉损伤171例,占比21.9%(冠脉损伤组),无冠状动脉损伤611例(无冠脉损伤组)。冠脉损伤组的皮疹、肢端硬性红肿、球结膜充血、杨梅舌等临床表现占比分别为83.6%、67.8%、86.0%、81.9%,高于无冠脉损伤组的63.5%、49.7%、62.5%、65.3%(P<0.05)。冠脉损伤组与无冠脉损伤组的性别、年龄、血红蛋白、血红细胞沉降率(ESR)等比较差异无统计学意义(P>0.05),冠脉损伤组的丙氨酸氨基转移酶、白细胞计数(WBC)、D-二聚体(D-D)、C-反应蛋白(CRP)、降钙素原(PCT)、血小板计数(PLT)、发热时间与无冠脉损伤组比较差异有统计学意义(P<0.05)。多因素Logistic逐步回归分析显示,WBC、D-D、CRP、PCT、PLT、发热时间均为川崎病患儿发生冠状动脉损伤的影响因素(P<0.05)。结论 KD儿童中,冠状动脉损伤发生率较高,可导致患儿临床特征多样化,加重患儿的病情,WBC、D-D、CRP、PCT、PLT、发热时间为导致冠状动脉损伤发生的影响因素。
Objective To investigate the incidence of coronary artery injury in children with Kawasaki disease(KD)and analyze the risk factors.Methods From January 2018 to December 2022,782 children with KD diagnosed and treated in Quanzhou Women’s and Children’s Hospital were selected as the study subjects.All the children were given ultrasound examination on admission to determine the coronary artery injury level.The general information of all the children was investigated and the risk factors were analyzed.Results Among the 782 children,171 cases(21.9%)were diagnosed as the“coronary artery injury group”.The remaining 611 patients did not exhibit any coronary artery injury and were thus categorized as the“no coronary artery injury group”.The clinical manifestations incidences of rashes,hard red swelling of extremity,bulbar conjunctival congestion and bayberry tongue in the coronary injury group were 83.6%,67.8%,86.0% and 81.9%,respectively,which were significantly higher than those in the non-coronary injury group(63.5%,49.7%,62.5% and 65.3%,P<0.05).There were no significant differences in gender,age,hemoglobin and erythrocyte sedimentation rate between the coronary injury group and the no coronary injury group(P>0.05).There were significant differences in alanine aminotransferase,white blood cell count(WBC),D-dimer(D-D),C-reactive protein(CRP),procalcitonin(PCT),platelet count(PLT)and fever duration between the two groups(P<0.05).Multivariate Logistic stepwise regression analysis showed that WBC,D-D,CRP,PCT and PLT were all important factors leading to coronary artery injury(P<0.05).Conclusions The incidence of coronary artery injury in children with KD is relatively high,which can lead to the diversification of clinical features and disease aggravation of children.WBC,D-D,CRP,PCT,PLT and fever duration are important risk factors for the occurrence of coronary artery injury.
论著

GuideLiner®延长导管在复杂经皮冠状动脉介入治疗中的临床经验

Clinical efficacy and safety of GuideLiner® guide extension catheter application during complex coronary percutaneous coronary intervention procedure

:28-32
 
目的 总结GuideLiner®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。
Objective To evaluate the clinical efficacy and safety of GuideLiner® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.
护理研究

远程药学管理模式联合延续护理在2型糖尿病合并冠状动脉病变患者居家用药中的研究

Study on home medication of type 2 diabetes patients with coronary artery disease by remote pharmaceutical management mode combined with continuous nursing

:427-431
 
目的 探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。
Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus(T2DM)patients with coronary artery disease.Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects.They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods.The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group.Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale(SF-36)] and incidence of adverse cardiovascular events were assessed.Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the Vitality(VT),Mental Health(MH),Emotional Function(RE),Physical Pain(BP),Physiological Function(PF),Social Function(SF),Physiological Function(RP)and Overall Health(GH)scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group(P<0.05).The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases(2.00%)and 15 cases(15.09%),respectively,with the study group significantly higher than the conventional group(χ2=10.865,P<0.05).Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events.
论著

血沉对川崎病冠状动脉病变的预测价值研究

Predictive value of erythrocyte sedimentation rate for coronary artery lesions in Kawasaki disease

:25-29
 
目的 探讨血沉(ESR)对川崎病(KD)冠状动脉病变(CAL)的预测价值。方法 收集 2017 年 5 月— 2021 年 6 月收治入院的KD患儿的临床资料,分析ESR对KD患儿CAL发生的预测作用。结果 纳入272例KD患儿,70例KD患儿合并CAL,202例KD患儿无CAL。KD患儿的ESR升高。单因素分析提示CAL组的ESR低于非CAL组,差异有统计学意义(P<0.05)。ROC曲线下的面积为0.586,提示ESR可作为CAL的预测因子(P<0.05)。ESR预测川崎病冠脉病变发生的临界值为76.5 mm/h。二分类Logistic回归分析显示,ESR是KD患儿发生CAL的独立危险因素(P<0.05),当ESR<76.5 mm·h-1时,KD患儿CAL发生风险增加 (OR=2.38,95% CI: 1.25~4.53)。结论 KD急性期的ESR水平可用于预测KD患儿CAL的发生,ESR<76.5 mm·h-1时,提示KD患儿可能会出现CAL。
Objective To investigate the predictive value of erythrocyte sedimentation rate (ESR) on coronary artery lesions (CAL) in Kawasaki disease (KD). Methods Clinical data of children with KD admitted to the hospital from May 2017 to June 2021 were collected to analyze the predictive value of ESR on the occurrence of CAL in children with KD. Results Of the 272 enrolled children with KD, 70 children with CAL and 202 children without CAL. ESR was significantly higher in children with KD. Univariate analysis suggested that ESR was lower in the CAL group than in the non-CAL group, and the difference was statistically significant (P<0.05). The area under the ROC curve was 0.586, suggesting that ESR could be a predictor of CAL (P<0.05). The critical value of ESR for predicting the occurrence of CAL in KD was 76.5 mm/h. Dichotomous Logistic regression analysis showed that ESR was an independent risk factor for the development of CAL in children with KD (P<0.05), and the risk of CAL in children with KD was significantly increased when ESR was<76.5 mm/h. (OR = 2.38, 95% CI: 1.25-4.53). Conclusions ESR levels in the acute phase of KD can be used to predict the development of CAL in children with KD, and ESR <76.5 mm/h suggests that children with KD may develop CAL.
论著

NLR、PLR、MLR与冠状动脉疾病严重程度的相关性分析

The correlation of NLR,PLR and MLR with coronary artery disease severity

:30-35
 
目的 探讨接受冠状动脉造影患者的中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)和单核细胞-淋巴细胞比值(MLR)与冠状动脉疾病(CAD)严重程度的关系。方法 收集2021年1月—2021年12月在六安市人民医院接受冠状动脉造影的150例急性冠脉综合征(ACS)患者。CAD的严重程度通过Gensini评分进行评估,150例ACS患者根据评分被分为轻度病变组(≤14分,41例)、中度病变组(15~47分,69例)和重度病变组(≥48分,40例)。比较3组的临床指标,采用相关统计学分析NLR、PLR、MLR与CAD严重性(Gensini评分)的相关性。结果 纳入研究的150例患者的平均年龄为(66.49±11.43)岁,男性占67.3%。在重度病变组,NLR和PLR值高于其他两组。在Pearson相关性检验中,Gensini评分与NLR呈正相关(r=0.319,P<0.001),然而,Gensini评分与MLR、PLR之间无相关性(P>0.05)。在Logistic回归分析中,NLR(OR:1.306,95%CI:0.107~0.427)是CAD的独立危险因素。在ROC曲线分析中,发现NLR的曲线下面积最高,为0.723(95%CI:0.629~0.817,P<0.001),NLR≥0.25为识别CAD存在的最佳临界值,灵敏度为78.49%,特异度为60.26%。结论 根据Gensini评分,NLR与CAD的严重程度呈正相关,而研究中未观察到MLR、PLR与CAD严重程度之间的关联。
Objective To explore the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR)with coronary artery disease(CAD)severity in patients undergoing coronary angiography.Methods A total of 150 patients with acute coronary syndrome(ACS)who underwent coronary angiography in Lu'an People's Hospital from January 2021 to December 2021 were enrolled.The severity of CAD was assessed by Gensini score,according to the score,150 patients with ACS were divided into mild disease group(≤14 points,41 cases),moderate disease group(15-47 points,69 cases)and severe disease group(≥48 points,40 cases).Clinical indicators of the three groups were compared,and related statistics were used to analyze the correlation between NLR,PLR,MLR and the severity of coronary artery lesions(Gensini score).Results The average age of selected 150 patients was(66.49±11.43),67.3% were male.In the severe disease group,NLR,PLR values were higher than the other two groups.A positive significant correlation was found between Gensini score and NLR(r=0.319,P<0.001)by Pearson's correlation test.However,no correlation was found between Gensini score and MLR and PLR(P>0.05).In the Logistic regression analysis,NLR(OR:1.306,95% CI:0.107-0.427)was the independent risk factor of CAD.In receiver operating characteristic curve analysis,NLR was found to have highest area under the curve at 0.723(95% CI:0.629-0.817,P<0.001),with an optimal cut-off value of 0.25,predicting the severe coronary lesion with a sensitivity of 60.26% and specificity of 78.49%.Conclusions The NLR is positively correlated with the severity of CAD.No correlation between MLR,PLR and severity of CAD in the cohort were observed.
临床诊疗

血清脂滴蛋白-5表达水平与STEMI老年患者冠状动脉病变及近远期预后的相关性

:92-94
 
目的 探究血清脂滴蛋白-5表达水平与ST段抬高型心肌梗死(STEMI)老年患者冠状动脉病变和预后的相关性。方法 对2016年1月—2018年1月的100例STEMI老年患者进行研究,所有患者于入院次日晨起空腹状态下检测血清脂滴蛋白-5表达水平,根据中位值分成高表达组(对照组)和低表达组(观察组)各50例,比较不同表达水平患者的冠状动脉病变支数、死亡率和不良事件发生率,分析血清脂滴蛋白-5表达水平与冠状动脉病变血管支数和预后的相关性。结果 2组冠状动脉血管单支、双支病变概率对比无差异(P>0.05);观察组3支病变概率为48.00%,高于对照组的24.00%,数据有差异(P<0.05);观察组治疗1个月、半年和3年后的死亡率分别为18.00%、28.00%和36.00%,高于对照组的2.00%、6.00%和12.00%,存在数据差异(P<0.05);观察组治疗1个月、半年和3年后的主要心血管不良事件发生率分别为30.00%、40.00%和48.00%,数据对比有差异(P<0.05);血清脂滴蛋白-5表达水平与病变支数为负相关关系,与近远期预后为正相关关系(r=-0.754,P=0.008;r=0.816,P=0.005)。结论 血清脂滴蛋白-5表达水平与STEMI老年患者冠脉病变严重性和近远期预后密切相关:表达水平低,病情越严重,预后越差。
论著

冠心病患者血清HCY、HO-1水平及其与冠状动脉Gensini积分的相关性研究

Study of serum HCY and HO-1 levels in patients with coronary artery disease and their correlation with coronary Gensini score

:72-75
 
目的 探究冠心病患者血清同型半胱氨酸(HCY)、血红素加氧酶-1(HO-1)水平与冠状动脉Gensini积分的相关性,并对其进行分析与探讨。方法 随机选取2020年3月—2021年7月于我院心内科行冠脉造影确诊的冠心病患者108例作为观察组和同期于我院行冠脉造影排除冠心病的健康人群33例作为对照组。根据冠心病患者的Gensini积分将其分为低分组(n=42)、中分组(n=35)和高分组(n=31)。对比观察组与对照组2组研究对象血清HCY、HO-1水平差异,冠心病患者的血清HCY、HO-1水平与Gensini积分的相关性通过Pearson相关分析法分析。结果 观察组血清HCY水平高于对照组(P<0.05);观察组血清HO-1水平低于对照组血清HO-1水平(P<0.05)。高分组血清HCY水平高于中分组和低分组(P<0.05);高分组血清HO-1水平低于中分组和低分组(P<0.05)。血清HCY水平与Gensini积分呈正相关(P<0.05),血清HO-1水平与Gensini积分呈负相关(P<0.05)。结论 血清HCY、HO-1水平与冠心病患者Gensini积分密切相关。
Objective To investigate the correlation between serum homocysteine (HCY), heme oxygenase-1 (HO-1) levels and coronary Gensini score in patients with coronary artery disease. Methods One hundred and eight patients with coronary artery disease diagnosed by coronary angiography in the cardiology department of our hospital from March 2020 to July 2021 were randomly included in observation group, while 33 healthy people without coronary artery disease confirmed by coronary angiography in our hospital during the same period as the control group. The 108 patients with coronary artery disease were divided into low (n=42), medium (n=35) and high (n=31) groups by coronary Gensini score. The differences in serum HCY and HO-1 levels between observation group and control group were compared, and the correlation between serum HCY, HO-1 levels and coronary Gensini score was analyzed by Pearson correlation analysis. Results The serum HCY level of the observation group was higher than that of the control group (P<0.05); the serum HO-1 level of the observation group was lower than that of the control group (P<0.05). The serum HCY level in the high group was higher than the middle group and low group (P<0.05); the serum HO-1 level in the high group was lower than the middle group and low group (P<0.05). Serum HCY level was positively correlated with coronary Gensini score (P<0.05), and serum HO-1 level was negatively correlated with coronary Gensini score (P<0.05). Conclusions Serum HCY and HO-1 levels were closely correlated with coronary Gensini score in patients with coronary artery disease.
临床诊疗

中性粒细胞及淋巴细胞比值与急性冠状动脉综合征、冠状动脉狭窄程度的相关性研究

:136-138
 
目的 探讨中性粒细胞及淋巴细胞比值与急性冠状动脉综合征、冠状动脉狭窄程度的相关性。方法 选取2019年2月—2020年2月我院收治的急性冠状动脉综合征患者90例作为研究对象,根据检查结果将患者分为两组,分别为不稳定心绞痛组(51例)、急性心肌梗死组(39例),同时选取同期在我院检查且没有明显狭窄的患者52例作为对照组。对三组人群的中性粒细胞-淋巴细胞比值进行测定。比较三组人群中性粒细胞-淋巴细胞比值(NLR)、冠状动脉病变(Gensini)评分、不同冠状动脉病变狭窄患者NLR、Gensini评分、分析中性粒细胞-淋巴细胞比值与急性冠状动脉综合征、冠状动脉狭窄程度的相关性。结果 急性心肌梗死组NLR值大于不稳定心绞痛组、对照组(P<0.05),急性心肌梗死组Gensini评分高于不稳定心绞痛组、对照组(P<0.05);重度冠状动脉病变狭窄组NLR值大于中度狭窄组、轻度狭窄组(P<0.05),重度冠状动脉病变狭窄患者Gensini评分高于中度狭窄组、轻度狭窄组(P<0.05);NLR与急性冠状动脉综合征、冠状动脉狭窄程度呈正相关(r=0.236,P<0.05;r=0.214,P<0.05)。结论 中性粒细胞-淋巴细胞比值与急性冠状动脉综合征有明显的关系,且可以对患者的冠状动脉狭窄程度进行判断。
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