本文選題：急性心力衰竭 + 室性期前收縮�。� 參考：《臨床心血管病雜志》2017年06期

【摘要】：目的:探討急性心力衰竭(心衰)患者急性期室性期前收縮(室早)的數(shù)量及性質(zhì)對于長期預(yù)后及危險分層評估的臨床價值。方法:對從2012-03-2015-02共入組230例急性心衰患者隨訪18個月后,分析死亡組和非死亡組各項臨床指標(biāo)以及室早的數(shù)量及性質(zhì),對急性心衰患者長期預(yù)后的影響。終點事件定義為全因死亡。結(jié)果:室早總數(shù)(P=0.005)、多形性室早(P=0.03)與急性心衰患者18個月的死亡風(fēng)險相關(guān),而非持續(xù)性室性心動過速與急性心衰患者18個月死亡風(fēng)險無明顯相關(guān)性。多因素COX回歸模型發(fā)現(xiàn)急性心衰患者急性期室早總數(shù)(HR1.193,P=0.04)、NT-proBNP、血鈉及收縮壓是全因死亡的獨立預(yù)測因子。ROC曲線示室早總數(shù)曲線下面積(AUC)為0.642,最佳預(yù)測值為1 193次/24h,敏感性53.7%,特異性73.6%。Kaplan-Meier生存曲線顯示頻發(fā)多形性室早患者全因死亡率更高。結(jié)論:急性心衰患者急性期室早數(shù)量作為長期預(yù)后及危險分層的預(yù)測指標(biāo),具有一定的臨床價值。
[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.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院心臟病科;
【基金】：國家科技支撐計劃課題(No:2011BAI11B08) 江蘇省六大人才高峰資助項目[No:WSN-031(IB15)]
【分類號】：R541.6

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