血清25-羟维生素-D3 超敏C反应蛋白及心电图参数与ST段抬高型心肌梗死患者介入治疗后发生恶性心律失常的关系

doi:10.3969/j.issn.1006-6233.2023.02.016

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Abstract Objective: To investigate the relationship between the changes of serum 25 hydroxyvitamin D3 (25-(OH)-D3), high sensitivity C-reactive protein (hs CRP), ECG parameters, and malignant arrhythmia after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 193 STEMI patients who underwent PCI in our hospital from January 2020 to June 2022 were selected as the research subjects. According to whether the patients had malignant arrhythmias within 72 hours after surgery, they were divided into the arrhythmia group of 38 cases and the control group of 155 cases. The 25-(OH)-D3, hs-CRP, serum electrolytes, blood routine indexes, blood lipid indexes, and myocardial enzyme indexes of the patients in the groups were compared within 12 hours of admission, and the patients were monitored by continuous dynamic electrocardiogram after PCI. The fragmented QRS complex, corrected Tp-e interval (Tp-ec), QT dispersion (Qtd), and logistic regression model were used to analyze the relationship between the above indicators and the occurrence of malignant arrhythmia in STEMI patients after PCI. Results: The level of serum 25-(OH)-D3 in patients with arrhythmia was lower than that in the control group. The detection rates of hs CRP, Tp-ec, Qtd, and fragmented QRS waves in patients with arrhythmia were higher than those in the control group. The differences between the above indicators were statistically significant (P<0.05); the levels of white blood cell (WBC), troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), K⁺, Mg²⁺; logistic regression model showed that cTnI, CK-MB, potassium ion, hs CRP, Tp-ec, and Qtd increased, and positive fragmented QRS wave significantly increased the risk of malignant arrhythmia in STEMI patients after PCI (P<0.05); the increase of serum 25-(OH)-D3 level will reduce the risk of malignant arrhythmia in STEMI patients after PCI (P<0.05). Conclusion: The decrease of serum 25-(OH)-D3 level, the increase of hs-CRP, the increase of Tp-ec and Qtd after PCI, and the occurrence of the fragmented QRS complex in STEMI patients will increase the risk of malignant arrhythmia in patients.

Key words： 25-hydroxyvitamin-D3 High-sensitivity C-reactive protein Holter ST-segment elevation myocardial infarction Percutaneous coronary intervention Malignant arrhythmia

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.02.016 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I2/265

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