摘要
目的探讨左心房容积指数(LAVI)与急性冠脉综合征(ACS)患者主要心脏不良事件(MACE)的关系。方法选取2018年7月-2019年1月于陕西省咸阳市中心医院随诊的ACS患者198例作为研究对象,随访时间6个月,按是否发生MACE分为预后良好组(115例)和预后不良组(83例)。比较两组患者一般资料、LAVI、左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左心室射血分数(LVEF)的差异,分析MACE的影响因素,检验LAVI对ACS患者发生MACE的诊断效能。结果6个月的随访时间内,ACS患者MACE发生率为41.92%(83/198)。预后不良组年龄、Killp分级明显高于预后良好组,差异有统计学意义(P<0.05)。预后不良组LAVI、LAD、LVEDD及LVESD水平明显高于预后良好组,而LVEF水平明显低于预后良好组,差异有统计学意义(P<0.05)。logistic回归分析显示,年龄、Killp分级、LAVI是ACS患者发生MACE的危险因素(OR>1,P<0.05),LVEF是保护因素(OR<1,P<0.05)。LAVI预测ACS患者发生MACE的ROC曲线下面积为0.874(95%CI:0.819~0.929,P<0.001),截断值为27.00,准确度为0.671,敏感度和特异度分别为81.90%、85.20%。结论LAVI是ACS患者发生MACE的独立危险因素,且对MACE的诊断效能较高,据此早期干预以改善患者预后。
Objective To explore the relationship between left atrial volume index(LAVI)and major adverse cardiac events(MACE)in patients with acute coronary syndrome(ACS).Methods A total of 198 ACS patients who were followed up in Xianyang Central Hospital in Shaanxi Province from July 2018 to January 2019 were selected as the research objects.The follow-up time was six months.According to whether MACE occurred,they were divided into good prognosis group(115 cases)and poor prognosis group(83 cases).The differences in general information,LAVI,left atrial inner diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)between the two groups were compared.The influencing factors of MACE were analyzed and the diagnostic efficacy of LAVI for MACE in ACS patients were tested.Results During the 6-month follow-up,the incidence of MACE in ACS patients was 41.92%(83/198).The age and Killp grade in the poor prognosis group were significantly higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).The LAVI,LAD,LVEDD and LVESD levels in the poor prognosis group were significantly higher than those in the good prognosis group,while the LVEF levels were significantly lower than those in the good prognosis group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age,Killp grade,and LAVI were risk factors for MACE in ACS patients(OR>1,P<0.05),while LVEF was a protective factor(OR<1,P<0.05).The area under the ROC curve of LAVI predicting MACE in ACS patients was 0.874(95%CI:0.819-0.929,P<0.001),the cut-off value was 27.00,the accuracy was 0.671,the sensitivity and specificity were 81.90%,85.20%,respectively.Conclusion LAVI is an independent risk factor for MACE in ACS patients,and it has a high diagnostic efficiency for MACE.According to this,early intervention can improve the prognosis of patients.
作者
伊争伟
左红
王彦琛
YI Zhengwei;ZUO Hong;WANG Yanchen(Department of Cardiology,Xianyang Central Hospital,Shaanxi Province,Xianyang712000,China;Department of Geriatrics,Xianyang Central Hospital,Shaanxi Province,Xianyang712000,China)
出处
《中国医药导报》
CAS
2021年第2期52-55,60,共5页
China Medical Herald
基金
陕西省科学技术研究发展计划项目(2016SF221)。
关键词
急性冠脉综合征
心脏不良事件
左心房容积指数
危险因素
诊断效能
Acute coronary syndrome
Major adverse cardiac events
Left atrium volume index
Risk factors
Diagnostic efficiency
