心脏超声结合血清指标检查构建Logistic模型评估心律失常患者心功能分级的研究

doi:10.3969/j.issn.1006-6233.2025.02.028

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摘要 目的: 探究心脏超声结合血清指标检查构建Logistic模型评估心律失常(AR)患者心功能分级的研究。方法: 选取2021年2月至2024年4月本院收治的105例AR患者为研究对象(AR组),根据心功能分级标准,将AR患者分为Ⅰ~Ⅱ级组(n=45例)和Ⅲ~Ⅳ级组(n=60例)。同期选取在本院健康体检的志愿者为对照组(30例)。收集AR患者的临床资料,比较AR组和对照组、Ⅰ~Ⅱ级组和Ⅲ~Ⅳ级组的血清脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平及心脏超声参数[左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)]。采用Logistic回归分析筛选影响心功能分级的危险因素,并构建Logistic模型评估心脏超声参数及血清BNP、hs-CRP对心功能分级的诊断价值。结果: 与对照组相比,AR组LVEF明显下降,AR组LVEDD和LVESD明显升高,差异均有统计学意义(P<0.05)。AR组血清BNP和hs-CRP水平较对照组明显升高(P<0.05)。单因素分析显示,Ⅰ~Ⅱ级组和Ⅲ~Ⅳ级组在LVEF、LVEDD、LVESD、血清BNP和hs-CRP方面差异具有统计学意义(P<0.05)。Logistic多因素回归分析显示,LVEF水平降低,LVEDD、LVESD、BNP、hs-CRP水平升高均是影响心功能分级的危险因素(P<0.05)。ROC曲线分析显示,心脏超声指标联合血清BNP、hs-CRP构建的Logistic模型的AUC为0.907,敏感度为88.89%,特异度为78.33%,95%CI为0.913~0.977(P<0.05)。结论: 心脏超声联合血清BNP、hs-CRP构建Logistic模型对心律失常患者的心功能分级有较高的临床诊断价值,为临床评估心功能分级提供可靠依据。

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	李勉
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关键词 ：心脏超声, 超敏C反应蛋白, 脑钠肽, 心律失常, 心功能分级, Logistic模型

Abstract：Objective: To explore the study of Logistic model constructed by cardiac ultrasound with serum index in evaluating cardiac function grading in patients with arrhythmia (AR). Methods: Totally 105 AR patients in the hospital from February 2021 to April 2024 were enrolled (AR group). According to the grading of cardiac function, the AR patients were divided into grade I-II group (n=45) and grade III-IV group (n=60). At the same time, volunteers who received physical examination in the hospital were included in the control group (n=30). The clinical data of AR patients were collected, and the levels of serum brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) and cardiac ultrasound parameters (left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD] and left ventricular end-systolic diameter [LVESD]) were compared between AR group and control group, between grade Ⅰ~Ⅱ group and grade III-IV group. Logistic regression analysis was adopted to screen the risk factors affecting cardiac function grading, and a Logistic model was constructed to evaluate the diagnostic value of cardiac ultrasound parameters and serum BNP and hs-CRP on cardiac function grading. Results: Compared with the control group, the LVEF in the AR group was significantly decreased, while the LVEDD and LVESD were significantly increased (P<0.05). The levels of serum BNP and hs-CRP in the AR group were significantly enhanced compared with the control group (P<0.05). Univariate analysis indicated that there were statistical differences in LVEF, LVEDD, LVESD, serum BNP and hs-CRP between grade I-II group and grade Ⅲ~Ⅳ group (P<0.05). Logistic multivariate regression analysis demonstrated that the decrease of LVEF and increases of LVEDD, LVESD, BNP and hs-CRP were all risk factors affecting cardiac function grading (P<0.05). ROC curve analysis found that the AUC, sensitivity, specificity and 95% CI of the Logistic model constructed by cardiac ultrasound combined with serum BNP and hs-CRP were 0.907, 88.89%, 78.33% and 0.913-0.977, respectively (P<0.05). Conclusion: Logistic model constructed by cardiac ultrasound combined with serum BNP and hs-CRP has high clinical diagnostic value for cardiac function grading in AR patients, and it provides a reliable basis for clinical evaluation of cardiac function grading.

Key words： Cardiac ultrasound High-sensitivity C-reactive protein Brain natriuretic peptide Arrhythmia Cardiac function grading Logistic model

基金资助:2019年安徽省重点研究与开发计划项目,(编号:201904a07020008)

通讯作者: 张超学

引用本文:

李勉, 詹小林, 黄磊, 张超学. 心脏超声结合血清指标检查构建Logistic模型评估心律失常患者心功能分级的研究[J]. 河北医学, 2025, 31(2): 330-335.
LI Mian, ZHAN Xiaolin, HUANG Lei, et al. Study of Logistic Model Constructed by Cardiac Ultrasound with Serum Index in Evaluating Cardiac Function Grading in Patients with Arrhythmia. HeBei Med, 2025, 31(2): 330-335.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.02.028 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I2/330

[1] 郝修宏,王磊,高辉,等.老年射血分数降低心力衰竭患者住院期间恶性室性心律失常的发生情况及其对预后的影响[J].中华老年医学杂志,2024,43(6):697-703.
[2] 张金龙,郭靖涛,孙妮娜,等.慢性心力衰竭急性加重患者无创心功能评估指标与NYHA分级的相关性[J].河北医学,2023,29(10):1688-1692.
[3] 张尤佳,王焕勇,高明杰,等.颈动脉超声联合心脏超声对冠心病患者不良预后的评估价值[J].中国循证心血管医学杂志,2024,16(5):607-610.
[4] Fu Y,Pan Y,Gao Y,et al.Predictive value of CHA2DS2-VASc score combined with hs-CRP for new-onset atrial fibrillation in elderly patients with acute myocardial infarction[J].BMC Cardiovasc Disord,2021,21(1):1-8.
[5] 李志伟,叶圣权,高峰,等.不同剂量重组人脑利钠肽治疗老年难治性心力衰竭并室性心律失常的效果[J].国际老年医学杂志,2022,43(4):410-414.
[6] Hao G,Zhang H,Wang Y,et al.Effects of levocarnitine on cardiac function,urinary albumin,hs-CRP,BNP,and troponin in patients with coronary heart disease and heart failure[J].Hellenic Cardiol,2020,61(2):99-102.
[7] 中华医学会心电生理和起搏分会,中国医师协会心律学专业委员会.2020室性心律失常中国专家共识(2016共识升级版)[J].中华心律失常学杂志,2020,24(3):188-258.
[8] Ostrominski JW,Vaduganathan M,Claggett BL,et al.Dapagliflozin and New York Heart Association functional class in heart failure with mildly reduced or preserved ejection fraction:the DELIVER trial [J].Eur Heart Fail,2022,24(10):1892-1901.
[9] Sohns C,Zintl K,Zhao Y,et al.Impact of left ventricular function and heart failure symptoms on outcomes post ablation of atrial fibrillation in heart failure:CASTLE-AF trial[J].Circulation:arrhythmia and electrophysiology,2020,13(10):8461.
[10] Gopinathannair R,Dhawan R,Lakkireddy D R,et al.Predictors of myocardial recovery in arrhythmia‐induced cardiomyopathy:a multicenter study[J].Cardiovasc Electrophysiol,2021,32(4):1085-1092.
[11] Wang Y,Ma X.Relationship between changes of electrocardiogram indexes in chronic heart failure with arrhythmia and serum PIIINP and BNP[J].Exp Ther Med,2020,19(1):591-596.
[12] Hemmati R,Mohsenzadeh Y,Madadi R.Association between the increased level of high-sensitive CRP (hs CRP) and non-arrhythmic ECG changes and echocardiographic abnormalities in patients with acute coronary syndrome[J].Caspian Intern Med,2023,14(1):83.