Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, PR China.
Department of Cardiology, First Affiliated Hospital of Harbin Medical University, China.
Hellenic J Cardiol. 2019 Nov-Dec;60(6):366-371. doi: 10.1016/j.hjc.2018.04.003. Epub 2018 Apr 24.
To investigate the changes of ambulatory electrocardiography and peripheral blood SOD, MDA and Na+-K+-ATP enzymes in patients of acute myocardial infarction (AMI) complicated with arrhythmia.
From January 2012 to March 2015, 135 cases AMI complicated with arrhythmia in our hospital were divided into 2 groups: 70 cases in the AMI uncomplicated with arrhythmia and 65 cases in the AMI complicated with arrhythmia. 62 cases volunteers accepted physical examination in our hospital in the same period were collected as the control group. 24 hour-electrocardiogram detected by ambulatory electrocardiogram (AECG), SOD and MDA in peripheral blood detected by diagnostic reagent kit and Na+-K+-ATP enzymes in peripheral blood detected by malachite green Kit Method phosphate determination method were collected. ROC curve was used to evaluate the prognostic value of SOD, MDA and Na+-K+-ATP enzymes in AMI patients.
Compared with the control group, the patients had unusual ambulatory electrocardiography had increased (P <0.05), peripheral blood SOD and Na+-K+-ATP enzymes had decreased, peripheral blood MDA had increased in 2 AMI groups (P <0.05). Compared with AMI uncomplicated with arrhythmia group, the patients had unusual ambulatory electrocardiography had increased (P <0.05), peripheral blood SOD and Na+-K+-ATP enzymes had decreased, peripheral blood MDA had increased in AMI complicated with arrhythmia group (P <0.05). Among 135 cases AMI patients, 120 (88.9%) survived and 15 (11.1%) died, of whom 11 cases were AMI complicated with arrhythmia group, 4 cases were AMI uncomplicated with arrhythmia group. Compared with the AMI uncomplicated with arrhythmia group, the dead patients were more in the AMI complicated with arrhythmia group (c2 = 4.287, P = 0.038). Compared with the survival group, the SOD and Na+-K+-ATP enzymes were significantly lower (P <0.05) and MDA significantly higher (P <0.05) in the death group. The area under the ROC curve of SOD, MDA and Na+-K+-ATP enzymes were 0.958, 0.954 and 0.993 respectively, and the cut-off values were 30.66 ng/ml, 576.70 nmol/ml and 57.42 nmol/mgh, respectively.
Ambulatory electrocardiography has a close relationship with the peripheral blood SOD, MDA and Na+-K+-ATP enzymes in AMI patients complicated with arrhythmia, which might predict AMI condition.
探讨急性心肌梗死（AMI）合并心律失常患者动态心电图及外周血 SOD、MDA 和 Na+-K+-ATP 酶的变化。
选取 2012 年 1 月至 2015 年 3 月在我院治疗的 135 例 AMI 合并心律失常患者，根据心律失常发生情况分为 AMI 不合并心律失常组（70 例）和 AMI 合并心律失常组（65 例），同时选取同期在我院体检的 62 例志愿者作为对照组。采用动态心电图（AECG）检测 24 h 心电图，采用诊断试剂盒检测外周血 SOD 和 MDA，采用孔雀绿比色法测定试剂盒法检测外周血 Na+-K+-ATP 酶。绘制 ROC 曲线评估 SOD、MDA 和 Na+-K+-ATP 酶对 AMI 患者预后的预测价值。
与对照组相比，2 组 AMI 患者异常动态心电图比例增加（P＜0.05），外周血 SOD 和 Na+-K+-ATP 酶降低，MDA 升高（P＜0.05）。与 AMI 不合并心律失常组相比，AMI 合并心律失常组异常动态心电图比例增加（P＜0.05），外周血 SOD 和 Na+-K+-ATP 酶降低，MDA 升高（P＜0.05）。135 例 AMI 患者中，存活 120 例（88.9%），死亡 15 例（11.1%），其中 AMI 合并心律失常组 11 例，AMI 不合并心律失常组 4 例。与 AMI 不合并心律失常组相比，AMI 合并心律失常组死亡患者更多（c2=4.287，P=0.038）。与存活组相比，死亡组 SOD 和 Na+-K+-ATP 酶显著降低（P＜0.05），MDA 显著升高（P＜0.05）。SOD、MDA 和 Na+-K+-ATP 酶的 ROC 曲线下面积分别为 0.958、0.954 和 0.993，截断值分别为 30.66 ng/ml、576.70 nmol/ml 和 57.42 nmol/mgh。
AMI 合并心律失常患者动态心电图与外周血 SOD、MDA 和 Na+-K+-ATP 酶密切相关，可能有助于预测 AMI 病情。
