目的分析心电图P波特征指标、心房颤动血栓危险度评分(congestive heart failure hypertension age diabete mellitus stroke-vascular disease age sex category,CHA_(2)DS_(2)-VASc)联合血清糖链抗原125(carbohydrate antigen 125,CA1...目的分析心电图P波特征指标、心房颤动血栓危险度评分(congestive heart failure hypertension age diabete mellitus stroke-vascular disease age sex category,CHA_(2)DS_(2)-VASc)联合血清糖链抗原125(carbohydrate antigen 125,CA125)指标对住院心力衰竭患者新发心房颤动的预测价值。方法选取2022年1月至2023年8月在南京市浦口人民医院治疗的235例心力衰竭患者为研究对象,根据患者心房颤动的发生情况将其分为新发心房颤动组和非新发心房颤动组,收集患者的临床资料,对比新发心房颤动组和非新发心房颤动组患者的心电图P波特征指标,包括最小P波时限(minimum P-wave duration,P_(min))、最大P波时限(maximum P-wave duration,P_(max))、V_(1)导联P波终末电势(P terminal force in lead V_(1),PTFV_(1))、CHA_(2)DS_(2)-VASc评分、CA125等指标的差异,应用Pearson相关性分析P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125与心力衰竭患者新发心房颤动的相关性,最后通过受试者工作特征(receiver operating characteristic,ROC)及曲线下面积(area under curve,AUC)评价P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125对心力衰竭患者新发心房颤动的诊断价值。结果新发心房颤动组患者心电图P波特征指标P_(min)低于非新发心房颤动组患者,而P_(max),PTFV_(1)和CHA_(2)DS_(2)-VASc评分及CA125高于非新发心房颤动组患者[(68.05±9.34)ms/(75.36±10.61)ms、(163.76±14.35)ms/(148.90±12.47)ms、(0.065±0.015)mm/s/(0.059±0.008)mm/s、(3.91±1.52)分/(3.05±1.15)分、(84.62±18.54)U/mL/(71.28±16.34)U/mL];logistic回归分析显示,P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125水平升高和P_(min)降低是新发心房颤动的危险因素(OR=1.059,95%CI:1.021~1.098,P<0.05;OR=1.963,95%CI:1.185~3.250,P<0.05;OR=1.474,95%CI:1.064~2.042,P<0.05;OR=1.049,95%CI:1.016~1.082,P<0.05;OR=-0.051,95%CI:0.913~0.989,P<0.05)。P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分及CA125与心力衰竭患者新发心房颤动呈正相关(r=0.374,P<0.001;r=0.334,P<0.001;r=0.302,P<0.001;r=0.288,P<0.001),而P_(min)与心力衰竭患者新发心房颤动呈负相关(r=-0.278,P<0.001)。ROC曲线结果显示,P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125联合检测预测心力衰竭患者新发心房颤动的AUC值高于各指标单独检测(0.916/0.687、0.771、0.707、0.671、0.729,P<0.05)。结论心力衰竭住院患者P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分及CA125水平与心力衰竭住院患者新发心房颤动的发生有较高相关性,且心电图P波特征指标、CHA_(2)DS_(2)-VASc评分和血清CA125联合检测心力衰竭住院患者新发心房颤动的诊断效能优于各指标单独检测。展开更多
文摘目的分析心电图P波特征指标、心房颤动血栓危险度评分(congestive heart failure hypertension age diabete mellitus stroke-vascular disease age sex category,CHA_(2)DS_(2)-VASc)联合血清糖链抗原125(carbohydrate antigen 125,CA125)指标对住院心力衰竭患者新发心房颤动的预测价值。方法选取2022年1月至2023年8月在南京市浦口人民医院治疗的235例心力衰竭患者为研究对象,根据患者心房颤动的发生情况将其分为新发心房颤动组和非新发心房颤动组,收集患者的临床资料,对比新发心房颤动组和非新发心房颤动组患者的心电图P波特征指标,包括最小P波时限(minimum P-wave duration,P_(min))、最大P波时限(maximum P-wave duration,P_(max))、V_(1)导联P波终末电势(P terminal force in lead V_(1),PTFV_(1))、CHA_(2)DS_(2)-VASc评分、CA125等指标的差异,应用Pearson相关性分析P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125与心力衰竭患者新发心房颤动的相关性,最后通过受试者工作特征(receiver operating characteristic,ROC)及曲线下面积(area under curve,AUC)评价P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125对心力衰竭患者新发心房颤动的诊断价值。结果新发心房颤动组患者心电图P波特征指标P_(min)低于非新发心房颤动组患者,而P_(max),PTFV_(1)和CHA_(2)DS_(2)-VASc评分及CA125高于非新发心房颤动组患者[(68.05±9.34)ms/(75.36±10.61)ms、(163.76±14.35)ms/(148.90±12.47)ms、(0.065±0.015)mm/s/(0.059±0.008)mm/s、(3.91±1.52)分/(3.05±1.15)分、(84.62±18.54)U/mL/(71.28±16.34)U/mL];logistic回归分析显示,P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125水平升高和P_(min)降低是新发心房颤动的危险因素(OR=1.059,95%CI:1.021~1.098,P<0.05;OR=1.963,95%CI:1.185~3.250,P<0.05;OR=1.474,95%CI:1.064~2.042,P<0.05;OR=1.049,95%CI:1.016~1.082,P<0.05;OR=-0.051,95%CI:0.913~0.989,P<0.05)。P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分及CA125与心力衰竭患者新发心房颤动呈正相关(r=0.374,P<0.001;r=0.334,P<0.001;r=0.302,P<0.001;r=0.288,P<0.001),而P_(min)与心力衰竭患者新发心房颤动呈负相关(r=-0.278,P<0.001)。ROC曲线结果显示,P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分,CA125联合检测预测心力衰竭患者新发心房颤动的AUC值高于各指标单独检测(0.916/0.687、0.771、0.707、0.671、0.729,P<0.05)。结论心力衰竭住院患者P_(min),P_(max),PTFV_(1),CHA_(2)DS_(2)-VASc评分及CA125水平与心力衰竭住院患者新发心房颤动的发生有较高相关性,且心电图P波特征指标、CHA_(2)DS_(2)-VASc评分和血清CA125联合检测心力衰竭住院患者新发心房颤动的诊断效能优于各指标单独检测。
