摘要
目的探究冠状动脉慢血流(coronary slow flow,CSF)现象的动态心电图特点,并分析相关影响因素。方法回顾性分析行冠状动脉造影的108例疑似冠心病患者的临床资料,依据TIMI血流分级将患者分为慢血流组(≤2级,n=58)与血流正常组(3级,n=50)。对所有患者行动态心电图检查,并分析CSF现象的动态心电图特点及相关的影响因素。结果两组患者年龄、高血压、糖尿病、饮酒史,服用双抗血小板药物、降脂药、血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂、钙通道阻滞剂、β受体阻滞剂、单硝酸异山梨酯者占比对比,差异均无统计学意义(均P>0.05);慢血流组男性、吸烟史、高尿酸病例数占比高于血流正常组,差异均有统计学意义(均P<0.05);两组短阵房性心动过速、短阵室性心动过速、房性早搏、室性早搏、T波改变、左或右束支阻滞、房室阻滞占比相比,差异均无统计学意义(均P>0.05);两组相邻RR间期差异≥50 ms的百分数(pNN50)、连续5 min RR间期标准差(SDANN)、相邻正常RR间期差值均方根(rMSSD)相比,差异均无统计学意义(均P>0.05);慢血流组最高心率、正常窦性RR间期标准差(SDNN)明显低于血流正常组,差异均有统计学意义(均P<0.05);两组血红蛋白、总胆固醇、甘油三酯、丙氨酸转氨酶、天门冬氨酸转氨酶、白蛋白、凝血酶时间、D-二聚体水平对比,差异均无统计学意义(均P>0.05);慢血流组红细胞比容高于血流正常组,差异有统计学意义(P<0.05)。选取一般资料、动态心电图检查结果、血液检测结果中影响CSF现象的5项因素进行多因素Logistic回归分析,结果表明,男性、有吸烟史、高尿酸、最高心率低、SDNN低是CSF现象的独立相关因素。结论男性、有吸烟史、高尿酸、最高心率低、SDNN低是CSF现象的独立相关因素,对预测冠心病患者CSF具有重要意义。
Objective To investigate the ambulatory electrocardiography(AECG)characteristics of coronary slow flow(CSF)phenomenon,and analyze its related influencing factors.Methods The clinical data of 108 patients with suspected coronary heart disease(CHD)who had undergone coronary angiography were retrospectively analyzed.According to the TIMI flow grade,patients were divided into a slow flow group(grade≤2,n=58)and a normal flow group(grade 3,n=50).All patients underwent 24-hour AECG monitoring to analyze the AECG characteristics of CSF and related influencing factors.Results There were no statistically significant differences between the two groups in age,hypertension,diabetes,history of alcohol consumption,or the use of dual antiplatelet agents,lipid-lowering drugs,ACEI/ARB,calcium channel blockers,beta-blockers or isosorbide mononitrate(all P>0.05).The proportions of males,smokers,and hyperuricemia were significantly higher in the slow flow group than those in the normal flow group(all P<0.05).There were no statistically significant differences in the incidence of paroxysmal atrial tachycardia,paroxysmal ventricular tachycardia,atrial premature beats,premature ventricular contraction,T-wave changes,left or right bundle branch block,or atrioventricular block between the two groups(all P>0.05).No statistically significant differences were observed in pNN50,SDANN or rMSSD(all P>0.05).The maximum heart rate and SDNN were significantly lower in the slow flow group than those in the normal flow group(both P<0.05).There were no statistically significant differences in hemoglobin,total cholesterol,triglycerides,alanine aminotransferase,aspartate aminotransferase,albumin,thrombin time,or D-dimer levels between the two groups(all P>0.05).Hematocrit was significantly higher in the slow flow group than that in the normal flow group(P<0.05).Five factors related to general information,AECG findings,and blood test results that affected the CSF phenomenon were selected for multivariate Logistic regression analysis.It showed that male,smoking history,hyperuricemia,low maximum heart rate,and low SDNN were independent influencing factors for CSF phenomenon.Conclusion Male sex,smoking history,hyperuricemia,low maximum heart rate,and low SDNN are independent related factors for coronary slow flow phenomenon and hold significant value in predicting CSF in patients with coronary heart disease.
作者
魏珂乐
袁义燕
詹雯
WEI Kele;YUAN Yiyan;ZHAN Wen(Department of Electrocardiogram,the Seventh People's Hospital of Zhengzhou,Zhengzhou Henan 450000,China)
出处
《实用心电与临床诊疗》
2025年第6期830-834,共5页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
关键词
冠状动脉慢血流现象
冠心病
动态心电图
危险因素
coronary slow flow phenomenon
coronary heart disease
ambulatory electrocardiography
risk factor
