心电图的碎裂QRS波联合血清pro-BNP对急性前壁心肌梗死患者心力衰竭的预测价值

doi:10.3969/j.issn.1006-6233.2024.02.020

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摘要 目的: 探究心电图的碎裂QRS波(fQRS波)联合血清前体脑钠肽(pro-BNP)对急性前壁心肌梗死(AAMI)患者心力衰竭的预测价值。方法: 选取2020年2月至2023年2月医院收治的145例AAMI患者作为研究对象,根据患者经皮冠状动脉介入术(PCI)术后3个月的心力衰竭发生情况将患者分为两组,统计心力衰竭组与非心力衰竭组患者一般资料,两组均进行常规12导联心电图检查与血清pro-BNP水平检测,分别采用Logistic回归分析与受试者工作特征(ROC)曲线分析AAMI患者心力衰竭的影响因素与fQRS波、pro-BNP及两者联合对心力衰竭发生的预测价值。结果: 145例患者中共76例(52.41%)患者发生心力衰竭,其余69例(47.59%)未发生心力衰竭;心力衰竭组血肌酐(Scr)水平、发病后治疗时间窗高于非心力衰竭组,术前病变支数多于非心力衰竭组(P<0.05);心力衰竭组存在心电图fQRS波的患者数多于非心力衰竭组,pro-BNP水平高于非心力衰竭组(P<0.05);心电图fQRS波、pro-BNP为AAMI患者心力衰竭的影响因素(P<0.05);心电图fQRS波、血清pro-BNP及联合对心力衰竭发生进行预测时,以pro-BNP的曲线下面积(AUC)值最高为0.800,敏感度、特异度分别为50.00%与85.65%,两者联合后敏感度显著升高,为84.21%,特异度为69.57%。结论: 心电图QRS波、pro-BNP为AAMI患者合并心力衰竭的影响因素,且心电图QRS波、pro-BNP在AAMI患者心力衰竭中预测效能较高,两者联合可显著提升敏感度,预测价值更高,可作为辅助检测指标。

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	何佩娟
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	宋小青

关键词 ：急性前壁心肌梗死, 心力衰竭, 心电图, 碎裂QRS波, 前体脑钠肽, 预测价值

Abstract：Objective: To investigate the predictive value of fragmented QRS (fQRS) complex on electrocardiogram combined with serum pro-brain natriuretic peptide (pro-BNP) for heart failure in patients with acute anterior myocardial infarction (AAMI). Methods: A total of 145 patients with AAMI were admitted to the hospital from February 2020 to February 2023. They were divided into two groups according to the presence or absence of heart failure in 3 months after percutaneous coronary intervention (PCI). General data of patients in the heart failure group and the non-heart failure group were collected. All patients completed routine 12-lead electrocardiogram and serum pro-BNP level detection. Logistic regression analysis was performed to identify the influencing factors of heart failure in patients with AAMI. The value of fQRS complex, pro-BNP, and their combination in predicting heart failure in patients with AAMI was analyzed using the ROC curve. Results: A total of 76 (52.41%) patients developed heart failure and 69 (47.59%) patients did not. Serum creatinine (Scr) level and therapeutic time window after onset in the heart failure group were higher/longer than those in the non-heart failure group. The diseased branches before operation were more than the non-heart failure group (P<0.05). Patients with fQRS complex on electrocardiogram in the heart failure group were more than the non-heart failure group, and pro-BNP level was higher than that in the non-heart failure group (P<0.05). fQRS complex on electrocardiogram and pro-BNP were influencing factors of heart failure in patients with AAMI (P<0.05). For single prediction of heart failure in patients with AAMI, the AUC of pro-BNP was the highest (0.800), with sensitivity of 50.00% and specificity of 85.65%. The sensitivity and specificity of joint prediction with the two indicators were of 84.21% and 69.57%. Conclusion: fQRS and pro-BNP are influencing factors for heart failure in AAMI patients. fQRS and pro-BNP have high prognostic value in HF in AAMI patients. The combination of them can significantly improve sensitivity and has higher prognostic value, which can be used as an auxiliary detection index.

Key words： Acute anterior myocardial infarction Heart failure Electrocardiogram Fragmented QRS complex Pro-brain natriuretic peptide Predictive value

基金资助:陕西省重点研发计划项目,(编号:2018FS-26)

通讯作者: 武金盼

引用本文:

何佩娟, 武金盼, 胡娟娟, 宋小青. 心电图的碎裂QRS波联合血清pro-BNP对急性前壁心肌梗死患者心力衰竭的预测价值[J]. 河北医学, 2024, 30(2): 277-281.
HE Peijuan, WU Jinpan, HU Juanjuan, et al. Predictive Value of Fragmented QRS Complex on Electrocardiogram Combined with Serum pro-BNP for Heart Failure in Patients with Acute Anterior Myocardial Infarction. HeBei Med, 2024, 30(2): 277-281.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.02.020 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I2/277

[1] 张婷,王祥贺,汤秀英,等.替罗非班在急性前壁心肌梗死合并糖尿病患者介入治疗中不同用药途径疗效差异研究[J].长春中医药大学学报,2022,38(5):543-547.
[2] 贾金烁,许长存,张晓莉,等.冠状动脉侧支循环在老年急性前壁心肌梗死患者PCI术中的心肌保护作用与预后研究[J].中国循证心血管医学杂志,2021,13(7):831-834.
[3] 辛国勇,郑高梅,唐伟.Cys-C、RBP联合UA对老年急性心肌梗死患者PCI术后心力衰竭的诊断价值[J].临床误诊误治,2023,36(5):73-77.
[4] 李婕,吕希俊,汪宏.心电图结合中性粒细胞/淋巴细胞比值对急性前壁心肌梗死患者PCI术后预后的预测价值[J].影像科学与光化学,2021,39(1):91-95.
[5] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.ST段抬高型心肌梗死基层诊疗指南(2019年)[J].中华全科医师杂志,2020,19(12):1083-1091.
[6] Zhou Y,Wang X,Lan S,et al.Application of evidence-based nursing in patients with acute myocardial infarction complicated with heart failure[J].Am Transl Res,2021,13(5):5641-5646.
[7] 支冬梅,李莉,陈程,等.QRS破碎波与急性心肌梗死患者冠状动脉病变相关参数及病变严重程度相关性研究[J].创伤与急危重病医学,2022,10(1):25-28.
[8] 周秀,廖晓现,成力.急性缺血性心力衰竭患者血清CIB1与pro-BNP的表达水平及意义[J].河北医药,2021,43(9):1316-1320.
[19] 赵闽.芪苈强心胶囊联合缬沙坦治疗对急性前壁心肌梗死患者心功能及不良心血管事件的影响[J].湖北中医药大学学报,2021,23(4):58-60.
[10] 李杰,张施明,杨淑莲.抗氧化应激对慢性心力衰竭患者CysC及Pro-BNP的影响及相关性[J].昆明医科大学学报,2020,41(1):31-36.
[11] 薛社亮,徐波,李文华,等.碎裂QRS波预测ARVC患者室性心律失常事件[J].临床心电学杂志,2022,31(3):168-171.