摘要
目的探讨与分析心脏超声参数积分系统对高海拔地区心力衰竭患者预后的风险评估价值。方法选择2020年8月—2022年7月玛沁县人民医院收治的高海拔地区心力衰竭患者76例,所有患者都给予心脏超声检查,记录常规超声指标,判定心脏超声参数积分,根据是否发生心血管不良事件将患者分为不良组与非不良组,随访患者的预后并进行Spearsman分析,COX回归分析,绘制ROC曲线进行风险评估分析。结果随访半年,76例患者中发生主要心血管不良事件16例(不良组)。不良组性别、年龄、身体质量指数、收缩压、舒张压、NYHA分级、原发疾病等与非不良组比较,差异无统计学意义(P>0.05);不良组心脏超声参数积显著高于非不良组,差异具有统计学意义(P<0.05);不良组左房内径、左室舒张末期内径、左室收缩末期内径、舒张早期血流速度大于非不良组,舒张晚期血流速度、左室射血分数、每搏输出量小于非不良组,差异具有统计学意义(P<0.05)。在76例患者中,Spearsman分析显示,舒张早期血流速度、心脏超声参数积分与预后主要心血管不良事件呈正相关,舒张晚期血流速度与预后主要心血管不良事件呈负相关(P<0.05);多因素COX回归分析显示,舒张早期血流速度、舒张晚期血流速度、心脏超声参数积分均为影响患者预后主要心血管不良事件的重要因素(P<0.05)。ROC曲线分析显示,心脏超声参数积分系统对高海拔地区心力衰竭患者预后的风险评估曲线下面积为0.889。结论高海拔地区心力衰竭患者在预后过程中容易发生主要心血管不良事件,可导致心脏超声参数积分发生异常,心脏超声参数积分系统对高海拔地区心力衰竭患者预后具有很好的风险评估价值,具有较高的临床应用价值。
Objective To explore and analyze the value of echocardiography parameter integration system in the risk assessment of prognosis of patients with heart failure at high altitude.Method From August 2020 to July 2022,76 patients with heart failure in high-altitude areas who were treated in Maqin County People's Hospital were selected as research objects.All patients were given cardiac ultrasound examination,routine ultrasound indexes were recorded,and cardiac ultrasound parameter integrals were determined.Patients were divided into adverse and non-adverse cardiovascular events according to the follow-up results.Spearsman analysis and COX regression analysis were performed to follow up the prognosis of patients,and ROC curve was drawn for risk assessment and analysis.Results After six months of follow-up,major cardiovascular adverse events occurred in 16 of 76 patients(adverse group).There were no signifi cant diff erences in gender,age,body mass index,systolic blood pressure,diastolic blood pressure,NYHA grade and primary disease in the adverse group compared with the non-adverse group(P>0.05).The score of cardiac ultrasound parameters in the adverse group which was signifi cantly higher than that in the non-adverse group(P<0.05).The left atrial diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter and early diastolic blood fl ow velocity in the poor group were higher than those in the non-adverse group(P<0.05),while the late diastolic blood fl ow velocity,left ventricular ejection fraction and stroke output in the poor group were lower than those in the non-adverse group(P<0.05).Among 76 patients,Spearsman analysis showed that early diastolic blood fl ow velocity and cardiac ultrasound parameter integral were positively correlated with prognostic major cardiovascular adverse events,while late diastolic blood fl ow velocity was negatively correlated with prognostic major cardiovascular adverse events(P<0.05).Multivariate COX regression analysis showed that early diastolic blood fl ow velocity,late diastolic blood fl ow velocity and cardiac ultrasound parameter integral were all important factors aff ecting the prognosis of patients with major cardiovascular adverse events(P<0.05).ROC curve analysis showed that the area under the curve of risk assessment of heart failure patients at high altitude was 0.889.Conclusion Major cardiovascular adverse events are likely to occur in patients with heart failure at high altitude during the prognosis process,which can lead to abnormal cardiac ultrasound parameter integration.Cardiac ultrasound parameter integration system has a good risk assessment value for the prognosis of patients with heart failure at high altitude,and has high clinical practical value.
作者
彭艳
PENG Yan(Department of Ultrasound,People's Hospital of Maqin County,Guoluo Qinghai,814099,China)
出处
《中华养生保健》
2023年第16期11-15,共5页
CHINESE HEALTH CARE
关键词
心脏超声参数积分系统
高海拔地区
心力衰竭
预后评估
舒张早期血流速度
舒张晚期血流速度
cardiac ultrasound parameter integration system
high altitude area
heart failure
prognosis evaluation
early diastolic blood fl ow velocity
late diastolic blood fl ow velocity
