摘要
目的探讨心电图aVR导联联合前体脑钠肽(pro-BNP)水平对急性前壁心肌梗死(AAMI)后心力衰竭的预测价值。方法选择2019年2月至2020年5月中国人民解放军联勤保障部队第九〇四医院收治的97例行经皮冠脉介入术(PCI)成功的AAMI患者为研究对象。根据患者术后3个月内是否并发心力衰竭分为心力衰竭组与非心力衰竭组。以logistic多因素回归法分析AAMI患者PCI术后3个月内并发心力衰竭的影响因素,以受试者操作特征(ROC)曲线分析术前心电图AVR导联ST段抬高、术前血浆pro-BNP水平及二者联合对AAMI患者PCI术后3个月内并发心力衰竭的预测价值。结果心力衰竭组发病后治疗时间窗、术前狭窄程度、术前血管病变支数、术前心电图aVR导联ST段抬高例数占比、术前血肌酐、血浆pro-BNP水平高于非心力衰竭组(P<0.05)。logistic多因素分析结果显示,术前心电图AVR导联ST段抬高、术前血浆pro-BNP水平为AAMI患者PCI术后3个月内并发心力衰竭的影响因素(P<0.05)。术前心电图AVR导联ST段抬高诊断AAMI患者PCI术后3个月内并发心力衰竭的灵敏度、特异度分别为82.69%、82.22%。ROC曲线结果显示,术前血浆pro-BNP水平及二者联合预测AAMI患者PCI术后3个月内并发心力衰竭的AUC值分别为0.728、0.866(P<0.05)。结论术前心电图AVR导联ST段抬高型、术前血浆pro-BNP水平在预测AAMI患者PCI术后3个月内并发心力衰竭中具有一定的价值,且联合检测的预测价值更高。
Objective To investigate the predictive value of AVR lead of electrocardiogram combined with pro-brain natriuretic peptide(pro-BNP)level in predicting heart failure after acute anterior myocardial infarction(AAMI).Methods From February 2019 to May 2020,a total of 97 patients with AAMI who underwent percutaneous coronary intervention(PCI)were selected as the research objects.Patients were divided into heart failure group and non-heart failure group according to whether they have heart failure within three months after surgery.The logistic multivariate regression method was used to analyze the influencing factors of heart failure in patients with AAMI within three months after PCI.Receiver operating characteristic(ROC)curve was used to analyze the preoperative ST segment elevation in aVR lead electrocardiogram,preoperative plasma pro-BNP level and their combined predictive value in AAMI patients with heart failure within three months after PCI.Results The time window of treatment after onset,the degree of preoperative stenosis,the number of preoperative vascular lesions,the proportion of ST segment elevation in aVR lead,the preoperative serum creatinine and plasma pro-BNP levels in the heart failure group were higher than those in the non-heart failure group(P<0.05).Logistic multivariate analysis showed that preoperative ST-segment elevation in aVR lead electroacrdiogram,and preoperative plasma pro-BNP level were the influencing factors for AAMI patients with heart failure within three months after PCI(P<0.05).The sensitivity and specificity of preoperative ST segment elevation in aVR lead electroacrdiogram in diagnosing AAMI patients with heart failure within three months after PCI were 82.69%and 82.22%,respectively.The ROC curve results showed that preoperative plasma pro-BNP level and the combination of the two predicted the AUC values of AAMI patients with heart failure within three months after PCI were 0.728,0.866,respectively(P<0.05).Conclusion Preoperative ST-segment elevation in aVR lead and preoperative plasma pro-BNP levels have certain value in predicting AAMI patients with heart failure within three months after PCI,and the combined detection has a higher predictive value.
作者
安冬梅
曹丽
刘洁
芮道荣
AN Dongmei;CAO Li;LIU Jie;RUI Daorong(Department of Cardiovascular Medicine,No.904 Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army,Jiangsu Province,Wuxi 214000,China;Department of Cardiovascular Medicine,Wuxi Fifth People’s Hospital,Jiangsu Province,Wuxi 214000,China;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Wannan Medical College,Anhui Province,Wuhu 241001,China)
出处
《中国医药导报》
CAS
2022年第23期49-52,61,共5页
China Medical Herald
基金
江苏省自然科学基金项目(BK20191118)。
关键词
心电图AVR导联
前体脑钠肽
急性前壁心肌梗死
心力衰竭
预测价值
aVR lead of electrocardiogram
Precursor brain natriuretic peptide
Acute anterior myocardial infarction
Heart failure
Predictive value
