摘要
目的:探究心电图的碎裂QRS波(fQRS波)联合血清前体脑钠肽(pro-BNP)对急性前壁心肌梗死(AAMI)患者心力衰竭的预测价值。方法:选取2020年2月至2023年2月医院收治的145例AAMI患者作为研究对象,根据患者经皮冠状动脉介入术(PCI)术后3个月的心力衰竭发生情况将患者分为两组,统计心力衰竭组与非心力衰竭组患者一般资料,两组均进行常规12导联心电图检查与血清pro-BNP水平检测,分别采用Logistic回归分析与受试者工作特征(ROC)曲线分析AAMI患者心力衰竭的影响因素与fQRS波、pro-BNP及两者联合对心力衰竭发生的预测价值。结果:145例患者中共76例(52.41%)患者发生心力衰竭,其余69例(47.59%)未发生心力衰竭;心力衰竭组血肌酐(Scr)水平、发病后治疗时间窗高于非心力衰竭组,术前病变支数多于非心力衰竭组(P<0.05);心力衰竭组存在心电图fQRS波的患者数多于非心力衰竭组,pro-BNP水平高于非心力衰竭组(P<0.05);心电图fQRS波、pro-BNP为AAMI患者心力衰竭的影响因素(P<0.05);心电图fQRS波、血清pro-BNP及联合对心力衰竭发生进行预测时,以pro-BNP的曲线下面积(AUC)值最高为0.800,敏感度、特异度分别为50.00%与85.65%,两者联合后敏感度显著升高,为84.21%,特异度为69.57%。结论:心电图QRS波、pro-BNP为AAMI患者合并心力衰竭的影响因素,且心电图QRS波、pro-BNP在AAMI患者心力衰竭中预测效能较高,两者联合可显著提升敏感度,预测价值更高,可作为辅助检测指标。
Objective:To investigate the predictive value of fragmented QRS(fQRS)complex on electrocardiogram combined with serum pro-brain natriuretic peptide(pro-BNP)for heart failure in patients with acute anterior myocardial infarction(AAMI).Methods:A total of 145 patients with AAMI were admitted to the hospital from February 2020 to February 2023.They were divided into two groups according to the presence or absence of heart failure in 3 months after percutaneous coronary intervention(PCI).General data of patients in the heart failure group and the non-heart failure group were collected.All patients completed routine 12-lead electrocardiogram and serum pro-BNP level detection.Logistic regression analysis was performed to identify the influencing factors of heart failure in patients with AAMI.The value of fQRS complex,pro-BNP,and their combination in predicting heart failure in patients with AAMI was analyzed using the ROC curve.Results:A total of 76(52.41%)patients developed heart failure and 69(47.59%)patients did not.Serum creatinine(Scr)level and therapeutic time window after onset in the heart failure group were higher/longer than those in the non-heart failure group.The diseased branches before operation were more than the non-heart failure group(P<0.05).Patients with fQRS complex on electrocardiogram in the heart failure group were more than the non-heart failure group,and pro-BNP level was higher than that in the non-heart failure group(P<0.05).fQRS complex on electrocardiogram and pro-BNP were influencing factors of heart failure in patients with AAMI(P<0.05).For single prediction of heart failure in patients with AAMI,the AUC of pro-BNP was the highest(0.800),with sensitivity of 50.00%and specificity of 85.65%.The sensitivity and specificity of joint prediction with the two indicators were of 84.21%and 69.57%.Conclusion:fQRS and pro-BNP are influencing factors for heart failure in AAMI patients.fQRS and pro-BNP have high prognostic value in HF in AAMI patients.The combination of them can significantly improve s
作者
何佩娟
武金盼
胡娟娟
宋小青
HE Peijuan;WU Jinpan;HU Juanjuan(The First Affiliated Hospital of Air Force Military Medical University,Shaanxi Xi'an 710032,China)
出处
《河北医学》
CAS
2024年第2期277-281,共5页
Hebei Medicine
基金
陕西省重点研发计划项目,(编号:2018FS-26)。
关键词
急性前壁心肌梗死
心力衰竭
心电图
碎裂QRS波
前体脑钠肽
预测价值
Acute anterior myocardial infarction
Heart failure
Electrocardiogram
Fragmented QRS complex
Pro-brain natriuretic peptide
Predictive value
