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作者	单位
王露露	安徽省阜阳市人民医院中心功能科安徽阜阳 236000
王高峰	阜阳市人民医院心内科安徽阜阳 236000
刘晓林	安徽省阜阳市人民医院中心功能科安徽阜阳 236000
张琰琰	安徽省阜阳市人民医院中心功能科安徽阜阳 236000
陈永玲	安徽省阜阳市人民医院中心功能科安徽阜阳 236000

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中文摘要:

摘要目的：探讨冠心病患者动态心电图参数与血清甲壳质酶蛋白40（YKL-40）、潜在转化生长因子结合蛋白2（LTBP-2）水平的关系。方法：选取本院2020年3月至2023年4月154例冠心病患者纳入冠心病组（其中单支病变38例，双支病变57例，多支病变59例；Gensini积分评估冠状动脉狭窄程度包括轻度42例，中度60例，重度52例），另选择于本院进行健康体检者90例纳入对照组，所有纳入对象均接受动态心电图检查，并检测血清YKL-40、LTBP-2水平，分析冠心病患者动态心电图参数与血清指标的关系。结果：冠心病组24 h内全部正常心动周期的标准差（SDNN）、每5 min正常R-R间期标准差（SDANN）、相邻正常心动周期差值均方根（RMSSD）、相邻2个正常心动周期差值＞50 ms个数百分比（PNN50）水平低于对照组，低频与高频功率之比（LF/HF）水平高于对照组（P＜0.05）；不同冠脉病变狭窄范围患者SDNN、SDANN、RMSSD、PNN50水平比较，多支病变＜双支病变＜单支病变，LF/HF水平比较，多支病变＞双支病变＞单支病变（P＜0.05）；不同冠脉病变狭窄程度患者SDNN、SDANN、RMSSD、PNN50水平比较，重度＜中度＜轻度，LF/HF水平比较，重度＞中度＞轻度（P＜0.05）；冠心病组血清YKL-40、LTBP-2水平高于对照组，且多支病变＞双支病变＞单支病变（P＜0.05）；不同冠脉病变狭窄程度患者血清YKL-40、LTBP-2水平比较，重度＞中度＞轻度（P＜0.05）；冠心病患者动态心电图参数SDNN、SDANN、RMSSD、PNN50水平与血清YKL-40、LTBP-2水平呈现负相关，LF/HF水平与血清YKL-40、LTBP-2水平呈现正相关（P＜0.05）。结论：冠心病患者血清YKL-40、LTBP-2呈高表达，且其表达水平随冠脉病变狭窄范围和严重程度增加而升高，与动态心电图指标SDNN、SDANN、RMSSD、PNN50水平呈现负相关，与LF/HF水平呈现正相关。

英文摘要:

ABSTRACT Objective: To explore the relationship between dynamic electrocardiogram parameters and levels of serum chitinase-3-like-1 protein (YKL-40) and latent transforming growth factor binding protein 2 (LTBP-2) in patients with coronary heart disease (CHD). Methods: A total of 154 patients with CHD in the hospital were enrolled as CHD group between March 2020 and April 2022, including 38 cases with single-vessel disease, 57 cases with double-vessel disease and 59 cases with multiple-vessel disease. The severity of coronary stenosis was evaluated by Gensini scores (42 mild cases, 60 moderate cases, 52 severe cases). A total of 90 healthy controls were enrolled as control group. All included objects underwent dynamic electrocardiogram examination. The levels of serum YKL-40 and LTBP-2 were detected, and their relationship with dynamic electrocardiogram parameters was analyzed. Results: The standard deviation of NN intervals (SDNN), standard deviation of average NN intervals (SDANN), square root of the mean of the squared differences between adjacent normal RR intervals/root mean square differences of successive R-R (RMSSD) and percent of NN50 in the total number of normal-to-normal intervals (PNN50) in CHD group were lower than those in control group, while ratio of low frequency to high frequency (LF/HF) was higher than that in control group (P<0.05). In patients with different ranges of coronary stenosis, SDNN, SDANN, RMSSD and PNN50 were the highest in those with single-vessel disease, followed by double-vessel disease and multiple-vessel disease, while LF/HF was on the contrary (P<0.05). In patients with different severity of coronary stenosis, SDNN, SDANN, RMSSD and PNN50 were the highest in those with mild stenosis, followed by moderate stenosis and severe stenosis, while LF/HF was on the contrary (P<0.05). The levels of serum YKL-40 and LTBP-2 in CHD group were higher than those in control group, and which were the highest in patients with multiple-vessel disease, followed by double-vessel disease and single-vessel disease (P<0.05). The levels of serum YKL-40 and LTBP-2 were the highest in patients with severe coronary stenosis, followed by moderate stenosis and mild stenosis (P<0.05). SDNN, SDANN, RMSSD and PNN50 were negatively correlated with levels of serum YKL-40 and LTBP-2, while LF/HF was positively correlated with them (P<0.05). Conclusion: The expression levels of serum YKL-40 and LTBP-2 are up-regulated in patients with CHD. With the increase of coronary stenosis range and severity, levels of serum YKL-40 and LTBP-2 were increased, and which are negatively correlated with SDNN, SDANN, RMSSD and PNN50, while positively correlated with LF/HF.

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