摘要
目的 探讨心肌损伤指标与血细胞指标检测应用于冠心病患者临床诊断与病情评估的效果.方法 选择2021年1月至2023年12月在我院治疗的150例冠心病患者作为冠心病组,并根据冠心病病情及症状表现分为无症状心肌缺血组42例,稳定型心绞痛组60例,不稳定型心绞痛组48例;同时选择在我院健康体检者150例作为对照组.观察比较各组的心肌损伤指标与血细胞指标检测结果,评估其对冠心病的诊断价值和病情评估价值.结果 冠心病组的心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶-MB(CK-MB)、心肌肌钙蛋白T(cTnT)、谷草转氨酶(AST)水平及红细胞体积分布宽度(RDW)水平均高于对照组,差异均具有统计学意义(均P＜0.05);冠心病组的血小板计数(PLT)、血小板分布寬度(PDW)及血小板平均体积(MPV)与对照组比较,差异均无显著统计学意义(均P＞0.05).不同病情及症状表现的冠心病患者中,无症状心肌缺血组、稳定型心绞痛组及不稳定型心绞痛组的cTnⅠ、CK-MB、cTnT、AST及RDW水平比较,差异均具有统计学意义(F=308.642、361.487、58.534、97.227、10.203,P＜0.05);稳定型心绞痛组的cTnⅠ、CK-MB、cTnT及AST水平均明显高于无症状心肌缺血组(t=11.969、12.135、4.714、6.275,P＜0.05),不稳定型心绞痛组的cTnⅠ、CK-MB、cTnT及AST水平均明显高于稳定型心绞痛组(t=15.166、15.759、6.679、8.095,P＜0.05)和无症状心肌缺血组(t=43.648、27.943、10.269、14.856,P＜0.05);不稳定型心绞痛组的RDW水平高于稳定型心绞痛组和无症状心肌缺血组(t=2.588、4.796,P＜0.05),稳定型心绞痛组RDW水平高于无症状心肌缺血组(t=0.035,P＜0.05).不同病情及症状表现的冠心病各组患者的PLT、PDW及MPV水平比较,差异均无统计学意义(均P＞0.05).结论 冠心病患者存在明显的心肌损伤,心肌损伤指标、血细胞指标中的RDW异常升高提示冠心病的可能,为冠心病诊断提供参考依据;心肌损伤指标及RDW水平与冠心病病情严重程度呈正比,可用于预测和评估患者病情变化.
Abstract
Objective To investigate the effect of myocardial injury index and blood cell index detection in clinical diagnosis and condition evaluation of patients with coronary heart disease.Methods 150 patients with coronary heart disease in our hospital from January 2021 to December 2023 were selected as the coronary heart disease group,and another 150 healthy subjects in our hospital dur-ing the same period were classified as the control group.The myocardial injury index and blood cell index detection results of the two groups were observed to evaluate their diagnostic value for coronary heart disease.The CHD group was divided into asymptomatic myo-cardial ischemia group(42 cases),stable angina pectoris group(60 cases)and unstable angina pectoris group(48 cases)according to their condition and symptom.The results of myocardial damage and blood cell indexes were compared between the three groups to evalu-ate the value of the evaluation of coronary heart disease.Results The levels of cTnⅠ,CK-MB,cTnT,AST and RDW in CHD group were higher than those in control group(P＜0.05).There were no significant differences in PLT,PDW and MPV between CHD group and control group(P＞0.05).In the CHD group,the results of cTnⅠ,CK-MB,cTnT,AST and RDW in the asymptomatic myocardial is-chemia group,stable angina pectoris group and unstable angina pectoris group were significantly different(F=308.642,361.487,58.534,97.227,10.203,P＜0.05);The levels of cTnⅠ,CK-MB,cTnT and AST in stable angina pectoris group were significantly high-er than those in asymptomatic myocardial ischemia group(t=11.969,12.135,4.714,6.275,P＜0.05).The levels of cTnl,CK-MB,cTnT and AST in unstable angina pectoris group were significantly higher than those in stable angina pectoris group(t=15.166,15.759,6.679,8.095,P＜0.05)and asymptomatic myocardial ischemia group(t=43.648,27.943,10.269,14.856,P＜0.05);RDW level in unstable angina pectoris group was higher than that in stable angina pectoris group and asymptomatic ischemia group(t=2.588,4.796,P＜0.05),and RDW level in stable angina pectoris group was higher than that in asymptomatic ischemia group(t=0.035,P＜0.05).There were no significant differences in PLT,PDW and MPV levels among the three groups(P＞0.05).Conclu-sion Patients with coronary heart disease have obvious myocardial injury.Abnormal increase of RDW in myocardial injury index and blood cell index can indicate the possibility of coronary heart disease,which can provide reference for the diagnosis of coronary heart disease.Moreover,myocardial injury index and RDW level are proportional to the severity of coronary heart disease,and can be used to predict and evaluate the change of patients'disease.
维普
万方数据