完全性右束支传导阻滞在评价急性心力衰竭患者预后中的价值

发布时间：2018-05-11 03:12

本文选题：急性心力衰竭 + 完全性右束支传导阻滞　；参考：《临床心血管病杂志》2017年09期

【摘要】：目的:探讨完全性右束支传导阻滞(CRBBB)与急性心力衰竭(AHF)患者长期病死率之间的相关性。方法:入选2012-03-2015-02因AHF入住我院的患者346例,收集与分析入选者的临床资料及入院时的相关检验及检查结果,前瞻性随访所有患者18个月,其终点事件为全因死亡。根据终点事件将其分为死亡组和生存组。结果:(1)39例(11.3%)失访,73例(23.8%)死亡;(2)完成随访的307例AHF患者中有35例(11.4%)合并CRBBB,其中生存组中有17例,而死亡组中18例(P0.01);(3)Kaplan-Meier分析后发现合并CRBBB的AHF患者死亡风险明显高于无CRBBB的AHF患者(P0.01);(4)CRBBB用于预测AHF患者预后的特异度可达92.7%(95%CI88.6~95.7),敏感度为24.7%(95%CI 15.3~36.1);(5)COX逐步回归分析(向前)显示,合并CRBBB的AHF患者比无CRBBB的AHF患者死亡风险超过2倍(HR=3.912,95%CI 2.208~6.933)。结论:CRBBB对评估AHF患者长期预后有重要价值。
[Abstract]:Aim: to investigate the relationship between complete right bundle branch block (CRBBB) and long term mortality in patients with acute heart failure (AHF). Methods: a total of 346 patients admitted to our hospital for AHF from 2012-03-2015-02 were enrolled. The clinical data of the selected patients were collected and analyzed. All patients were prospectively followed up for 18 months. They were divided into death group and survival group according to the end event. Results among the 307 cases of AHF, 35 cases (11.4%) were complicated with AHF, including 17 cases in the survival group (17 cases in the survival group, 17 cases in the survival group). However, the mortality risk of AHF patients with CRBBB was significantly higher than that of AHF patients without CRBBB by Kaplan-Meier analysis. The specificity for predicting the prognosis of AHF patients was 92.7%, 95% CI 88.6% (95.7%), and the sensitivity was 24.7%(95%CI 15.33% 36.1X stepwise regression analysis (forward). The risk of death in AHF patients with CRBBB was more than 2 times higher than that in AHF patients without CRBBB. Conclusion it is valuable to evaluate the long-term prognosis of AHF patients.
【作者单位】：南京医科大学第一附属医院心脏科;
【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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