广西医科大学学报2024,Vol.41Issue(1) :111-116.DOI:10.16190/j.cnki.45-1211/r.2024.01.016

妊娠期心脏疾病患者伴心力衰竭的多因素模型构建及妊娠结局分析

Multi-factor model construction and pregnancy outcome analysis of heart disease patients with heart failure during pregnancy

张雅 刘晓红 王影
广西医科大学学报2024,Vol.41Issue(1) :111-116.DOI:10.16190/j.cnki.45-1211/r.2024.01.016

妊娠期心脏疾病患者伴心力衰竭的多因素模型构建及妊娠结局分析

Multi-factor model construction and pregnancy outcome analysis of heart disease patients with heart failure during pregnancy

张雅 1刘晓红 1王影1
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作者信息

  • 1. 陕西省人民医院产科,西安 710068
  • 折叠

摘要

目的:构建妊娠期心脏疾病患者伴心力衰竭的多因素模型,并分析合并心力衰竭对妊娠结局的影响.方法:收集2021年1月至2022年12月陕西省人民医院产科收治的148例妊娠期心脏疾病患者为研究对象,随访至孕妇分娩,统计心力衰竭发生状况,将其分为伴心力衰竭组(56例)与单纯心脏疾病组(92例).对比两组临床资料,构建妊娠期心脏疾病患者伴心力衰竭的多因素logistic回归模型,探讨妊娠期心脏疾病患者发生心力衰竭的影响因素,并绘制受试者工作特征曲线(ROC)验证上述因素对患者发生心力衰竭的影响.结果:伴心力衰竭组妊娠期高血压、贫血、低蛋白血症、肺动脉高压发生率高于单纯心脏疾病组,脑钠肽(BNP)水平高于单纯心脏疾病组(P<0.05);Logistic回归模型结果显示,妊娠期高血压、贫血、低蛋白血症、肺动脉高压、高BNP水平是妊娠期心脏疾病患者发生心力衰竭的危险因素(OR=72.644、4.871、43.693、30.391、1.024,P<0.05).ROC曲线结果显示,AUC=0.934,模型可靠、稳定.伴心力衰竭组剖宫产率、产后出血率高于单纯心脏疾病组,新生儿Apgar评分低于单纯心脏疾病组(P<0.05).结论:妊娠期心脏疾病患者心力衰竭的发生可能与妊娠期高血压、贫血、低蛋白血症、肺动脉高压、高BNP水平有关,建立的logistic回归模型可预测妊娠期心脏疾病患者发生心力衰竭的可能性.

Abstract

Objective:To establish a multi-factor model of heart disease patients with heart failure during preg-nancy and analyze the influence of heart failure on pregnancy outcome.Methods:A total of 148 patients with heart disease during pregnancy admitted to the Department of Obstetrics of Shaanxi Provincial People's Hospital from January 2021 to December 2022 were collected as the research objects.The pregnant patients were followed up until the delivery,and the occurrence of heart failure was counted.They were divided into heart failure group(n=56)and simple heart disease group(n=92).The clinical data of the two groups were compared,a multivariate logistic regression model of heart disease patients with heart failure during pregnancy was constructed,the influ-encing factors of heart failure in patients with heart disease during pregnancy were explored,and the receiver op-erating characteristic(ROC)curve was drawn to verify the influence of the above factors on heart failure.Re-sults:The incidence of pregnancy-induced hypertension,anemia,hypoproteinemia and pulmonary hypertension in the heart failure group was higher than that in the simple heart disease group,and the level of brain natriuretic peptide(BNP)was higher than that in the simple heart disease group(P<0.05).Logistic regression model results showed that pregnancy-induced hypertension,anemia,hypoproteinemia,pulmonary hypertension and high BNP levels were the risk factors for heart failure in patients with heart disease during pregnancy(OR=72.644,4.871,43.693,30.391,1.024,P<0.05).The result of ROC curve showed that AUC was 0.934,and the model was reli-able and stable.The cesarean section rate and postpartum hemorrhage rate in the heart failure group were higher than those in the simple heart disease group,and the Apgar score of newborn was lower than that in the simple heart disease group(P<0.05).Conclusion:The occurrence of heart failure in patients with heart disease during pregnancy may be related to pregnancy-induced hypertension,anemia,hypoproteinemia,pulmonary hypertension and high BNP levels.The established logistic regression model can predict the possibility of heart failure in pa-tients with heart disease during pregnancy.

关键词

妊娠期心脏疾病/心力衰竭/多因素模型构建/妊娠结局

Key words

heart disease in pregnancy/heart failure/multi-factor model construction/pregnancy outcome

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基金项目

陕西省重点研发计划(2020SF-037)

出版年

2024
广西医科大学学报
广西医科大学

广西医科大学学报

CSTPCD
影响因子:0.788
ISSN:1005-930X
参考文献量15
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