| BackgroundWith the improvement of people's living standards,the incidence of coronary heart disease is increasing year by year.As a kind of emergency of coronary heart disease,acute coronary syndrome(ACS)is a common cause of death in patients with coronary heart disease.Coronary angiography is the "gold standard" in the diagnosis of coronary heart disease,but it is provided with a certain traumatic and it is not conducive for the primary hospital to diagnose ACS early in the requirements of technology.At present,the inflammation is considered to be connected with coronary heart disease closely.Looking for the inflammation indicators with both sensitivity and specificity to reflect the evolution of the disease is becoming the focus of clinical concern.Surface electrocardiogram is simple and convenient,shortcut and reproducible,so it is still an effective detection method for diagnosis of ACS.The joint detection of electrocardiogram(ECG)and markers of vascular inflammation has important significance for a comprehensive understanding the condition of myocardial injury,preliminary determination of ACS at early stage and preliminary assessment the next clinical treatment and prognosis of criminal vascular stenosis degree to patients with ACS.ObjectiveTo observed the changes of electrocardiogram(ECG)and vascular inflammation markers(CK-MB,cTnI,CRP,BNP and DD)of patients with ACS,and the relationship between coronary artery lesions,then further evaluate their clinical value in ACS,improve the diagnosis rate,reduce misdiagnosis and missed diagnosis in order to correct therapy in patient with ACS as soon as possible.MethodsSelect 118 cases of patients with ACS diagnosed by cardiovascular department in Xinxiang First People's Hospital from August 2013 to August 2015.The total of 118 patients include 57 cases of acute myocardial infarction(AMI),61 cases of unstable angina(UA),29 cases of stable angina pectoris(SAP)and 20 cases of healthy by selected as the control group.The patients' diagnosis is positive when coronary artery angiography(CAG)for any coronary artery stenosis is 50% or more.147 patients were divided into positive groups and negative groups according to the results CAG.Based on the different degrees of artery stenosis,the positive groups were divided into 50%-74% group and more than 75% group,or based on the number of diseased vessels,were divided into single vessel disease group,double vessel disease group and three vessel disease groups.Every group was analyzed respectively to their sensitivity of ECG and the levels of vascular inflammation markers.ResultsCompared ECG with CAG,the sensitivity for diagnosis of ACS has no significant difference(P > 0.05);through the diagnosis of ECG,the positive rate of group 50%-74%in coronary stenosis is 77.78% and group more than 75% is 95.79%;ECG in the diagnosis of single vessel of coronary artery stenosis is 81.82%,double branch lesions positive rate is93.75%,three or more positive rate is 96.36%.Plasma levels of CK-MB,cTnI,CRP,BNP and DD in AMI group were obviously higher than those in UA group(P < 0.01),the levels of CRP and BNP in ACS group were obviously higher than those in SAP group(P <0.05).There were no significant differences of these markers between SAP group and health group.Plasma levels of CKMB,cTnI,CRP,BNPand DD in more than 75% group is higher than those in 50%-74% group(P < 0.01 or P < 0.05);Plasma levels of CK-MB,cTnI,CRP,BNPand DD in Double vessel disease group and three vessel disease group were higher than those in single vessel disease group(P < 0.01 or P < 0.05).ConclusionWith aggravating the degree and increasing the number of coronary vascular lesions,the sensitivity of ECG is increased and the level of CK-MB?cTnI?CRP?BNP?DD is alsogradually increased.The joint detections above noninvasive examination method have important clinical reference value for the diagnosis of ACS. |
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