摘要
目的探讨急性冠脉综合征(ACS)患者的心电图特征与临床预后之间的关系,评估心电图在预后预测中的价值。方法回顾性分析在三门峡市中心医院确诊为ACS的100例患者的临床资料,记录其心电图特征,并结合随访数据评估其30 d内的主要不良心血管事件(MACE)。通过比较不同心电图特征在预后组间的分布差异,并构建Cox回归模型评估其对不良预后的预测作用。结果ST段抬高、T波显著倒置、心律失常、V_(1)导联T波倒置及心房颤动在预后不良组的发生率高于预后良好组(P<0.05)。基于这些心电图特征,构建了预后评分模型,受试者工作特征曲线分析表明模型具有良好的预测性能(曲线下面积为0.84,95%CI:0.76~0.92,截断值为3.5,敏感度为85%,特异度为70%,约登指数为0.55)。结论心电图特征在ACS患者的预后评估中具有重要价值,可通过简便的评分模型早期识别高危患者,从而优化治疗策略并改善临床结局。
Objective To investigate the relationship between electrocardiographic features and clinical prognosis in patients with acute coronary syndrome(ACS),and to evaluate the prognostic value of electrocardiogram in predicting clinical outcomes.Methods A retrospective analysis was conducted on clinical data from 100 patients diagnosed with ACS at Sanmenxia Central Hospital.Electrocardiographic features were recorded and combined with follow-up data to assess major adverse cardiac events(MACE)within 30 days.By comparing the distribution differences of various electrocardiographic features between prognostic groups,a Cox regression model was constructed to evaluate their predictive effect on adverse outcomes.Results The incidence rates of ST-segment elevation,significant T-wave inversion,arrhythmia,T-wave inversion in lead V_(1),and atrial fibrillation were higher in the poor prognosis group compared to the good prognosis group(P<0.05).Based on these electrocardiographic features,a prognostic scoring model was constructed.Receiver operating characteristic curve analysis demonstrated good predictive performance of the model(area under the curve was 0.84,95%CI:0.76-0.92,cutoff value was 3.5,sensitivity was 85%,specificity was 70%,Youden index was 0.55).Conclusion Electrocardiographic features have important value in prognostic assessment of ACS patients.A simple scoring model can be used for early identification of high-risk patients,thereby optimizing treatment strategies and improving clinical outcomes.
作者
曾涛
ZENG Tao(Emergency Medicine Department,Sanmenxia Central Hospital,Sanmenxia 472000,China)
出处
《河南医学研究》
2025年第23期4332-4336,共5页
Henan Medical Research
关键词
急性冠脉综合征
心电图特征
预后评估
不良心血管事件
风险预测
acute coronary syndrome
electrocardiographic features
prognostic assessment
adverse cardiovascular events
risk prediction
