摘要
目的:探讨心电图碎裂QRS波(fQRS)联合血清氨基末端脑钠肽前体(NT-proBNP)、Tei指数对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后主要不良心血管事件(MACE)的预测价值。方法:回顾性分析2016年5月~2020年6月本院收治的采取急诊PCI术治疗的120例STEMI患者的临床资料,均于术前行心电图、超声心动图检查及血清NT-proBNP水平监测。术后随访6个月,根据MACE发生情况,将其分为发生组与未发生组,对比此两组术前心电图fQRS、血清NT-proBNP及Tei指数,并采用Logistic回归性分析法分析术前心电图fQRS、血清NT-proBNP、Tei指数与STEMI患者PCI术后MACE发生的关系,另采用受试者工作特征(ROC)曲线评估术前心电图fQRS联合血清NT-proBNP、Tei指数对STEMI患者PCI术后MACE发生的预测价值。结果:120例STEMI患者PCI术后的MACE发生率为18.33%,发生组术前存在fQRS波占比及术前NT-proBNP水平、Tei指数均高于未发生组(P<0.05);经多因素Logistic回归分析,术前fQRS、术前NT-proBNP水平及Tei指数均是STEMI患者PCI术后发生MACE的危险因素(OR=4.802、3.579、3.313,P<0.05);根据ROC曲线,术前fQRS波、血清NT-proBNP水平、Tei指数单项及联合预测STEMI患者PCI术后MACE发生的灵敏度分别为95.45%、81.82%、77.27%、77.27%,特异度分别为57.14%、81.63%、82.65%、93.88%,曲线下面积(AUC)分别为0.856、0.904、0.862、0.942。结论:心电图fQRS、血清NT-proBNP水平、Tei指数均与STEMI患者PCI术后MACE的发生存在一定的关系,均对术后MACE的发生具有较好的预测价值,但联合检测的预测效能更佳。
Objective:To investigate the predictive value of electrocardiogram fragmented QRS complex(fQRS)combined with serum N-terminal pro brain natriuretic peptide(NT-proBNP)and Tei index for major adverse cardiovascular events(MACE)in patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods:The clinical data of 120 STEMI patients treated with emergency PCI in our hospital from May 2016 to June 2020 were retrospectively analyzed,and the electrocardiogram,echocardiography and serum NT-proBNP levels of them were detected before operation.The patients were followed up for 6 months and divided into occurrence group and non-occurrence group according to the occurrence of MACE,and the pre-operative electrocardiogram fQRS,serum NT-proBNP and Tei index were compared between the two groups,and the relationships between pre-operative electrocardiogram fQRS,serum NT-proBNP,Tei index and MACE in STEMI patients after PCI were analyzed by Logistic regression analysis method,then the predictive values of pre-operative electrocardiogram fQRS combined with serum NT-proBNP and Tei index for MACE in STEMI patients after PCI were analyzed by Receiver operating characteristic(ROC)curve.Results:The incidence of MACE in 120 STEMI patients after PCI was 18.33%,and the ratio of fQRS and NT-proBNP level and Tei index before operation in the occurrence group were higher than those in the non-occurrence group(P<0.05).Multivariate logistic regression analysis showed that pre-operative fQRS,pre-operative NT-proBNP level and Tei index were risk factors for MACE after PCI in STEMI patients(OR=4.802,3.579,3.313,P<0.05).According to ROC curve,the sensitivity of fQRS wave,serum NT-proBNP level and Tei index in single and combined predicting MACE of STEMI patients after PCI were 95.45%,81.82%,77.27%and 77.27%respectively,and the specificity were 57.14%,81.63%,82.65%and 93.88%,respectively and the area under the curve(AUC)were 0.856,0.904,0.862 and 0.942 respectively.Conclusion:Electrocardiog
作者
章东
江陈
张艳
Zhang dong;Jiang chen;Zhang yan(Third People's Hospital of Hefei)
出处
《现代科学仪器》
2021年第6期238-243,共6页
Modern Scientific Instruments
关键词
碎裂QRS波
氨基末端脑钠肽前体
TEI指数
急性ST段抬高型心肌梗死
经皮冠状动脉介入术
主要不良心血管事件
Fragmented QRS complex
N-terminal pro brain natriuretic peptide
Tei index
Acute ST segment elevation myocardial infarction
Percutaneous coronary intervention
Major adverse cardiovascular events
