室性期前收缩评估急性心力衰竭患者长期预后的临床价值

发布时间：2018-05-08 04:03

本文选题：急性心力衰竭 + 室性期前收缩　；参考：《临床心血管病杂志》2017年06期

【摘要】：目的:探讨急性心力衰竭(心衰)患者急性期室性期前收缩(室早)的数量及性质对于长期预后及危险分层评估的临床价值。方法:对从2012-03-2015-02共入组230例急性心衰患者随访18个月后,分析死亡组和非死亡组各项临床指标以及室早的数量及性质,对急性心衰患者长期预后的影响。终点事件定义为全因死亡。结果:室早总数(P=0.005)、多形性室早(P=0.03)与急性心衰患者18个月的死亡风险相关,而非持续性室性心动过速与急性心衰患者18个月死亡风险无明显相关性。多因素COX回归模型发现急性心衰患者急性期室早总数(HR1.193,P=0.04)、NT-proBNP、血钠及收缩压是全因死亡的独立预测因子。ROC曲线示室早总数曲线下面积(AUC)为0.642,最佳预测值为1 193次/24h,敏感性53.7%,特异性73.6%。Kaplan-Meier生存曲线显示频发多形性室早患者全因死亡率更高。结论:急性心衰患者急性期室早数量作为长期预后及危险分层的预测指标,具有一定的临床价值。
[Abstract]:Objective: to investigate the clinical value of the quantity and nature of ventricular premature contraction (VAP) in patients with acute heart failure (HF) for long term prognosis and risk stratification. Methods: a total of 230 patients with acute heart failure (AHF) from 2012-03-2015-02 were followed up for 18 months. The clinical indexes, the quantity and nature of ventricular premature, and the long-term prognosis of patients with acute CHF were analyzed. The endpoint event is defined as all-cause death. Results: the total number of ventricular premature and pleomorphic premature ventricular tachycardia were correlated with the risk of death in patients with acute heart failure at 18 months, but there was no significant correlation between non-persistent ventricular tachycardia and the risk of death in patients with acute heart failure at 18 months. Multivariate COX regression model showed that the total number of ventricular premature events in patients with acute heart failure (AHF) was HR1.193P0. 04 and NT-proBNPs. Blood sodium and systolic blood pressure were independent predictors of total death. The ROC curve showed that the area under the total number of ventricular premature events curve was 0. 642, the best predictive value was 1 193 times / 24 h, and the sensitivity was found to be 1 193 times / 24 h. The specific 73.6%.Kaplan-Meier survival curve showed that the mortality rate of multiple ventricular premature patients was higher. Conclusion: as a predictor of long-term prognosis and risk stratification in patients with acute heart failure, it is of clinical value.
【作者单位】：南京医科大学第一附属医院心脏病科;
【基金】：国家科技支撑计划课题(No:2011BAI11B08) 江苏省六大人才高峰资助项目[No:WSN-031(IB15)]
【分类号】：R541.6

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