摘要
目的:研究按心率校正的QT(QTc)、按心率校正的Tp-Te(Tp-Tec)间期联合血清脑钠肽(BNP)、半乳糖凝集素-3(Gal-3)预测急性心肌梗死(AMI)后室性心律失常(VA)的临床作用.方法:选取从2023年1月到7月在济南市人民医院接受治疗的AMI患者182例作为研究对象.根据住院期间是否发生VA进行分组,其中存在VA的71例患者作为观察组,不存在VA的111例患者作为对照组.检测并对比两组QTc、Tp-Tec以及血清BNP、Gal-3水平.多因素Logistic回归分析AMI后并发VA的影响因素,受试者工作特征(ROC)曲线分析QTc、Tp-Tec联合血清BNP、Gal-3对AMI后并发VA的预测效能.结果:观察组QTc、Tp-Tec以及血清BNP、Gal-3水平较对照组更高(P＜0.05).多因素Logistic回归分析发现QTc、Tp-Tec、BNP及Gal-3升高及血管病变支数为双支/多支为AMI后并发VA的危险因素.ROC曲线分析发现,QTc、Tp-Tec、BNP及Gal-3联合检测对AMI后并发VA的预测效能最佳,其中AUC为0.864,敏感度为92.50％,特异度为79.83％,约登指数为0.723.结论:AMI后并发VA患者的QTc、Tp-Tec、BNP及Gal-3水平升高,且是AMI后并发VA的危险因素.QTc、Tp-Tec、BNP及Gal-3联合检测对AMI后VA具有较好的预测价值.
Abstract
Objective:To study the clinical effect of heart rate corrected QT(QTc),heart rate corrected Tp-Te(Tp-Tec)interval combined with serum brain natriuretic peptide(BNP)and galectin-3(Gal-3)in predicting ventricular arrhythmia(VA)after acute my-ocardial infarction(AMI).Methods:182 AMI patients who were treated in Jinan People's Hospital from January to July 2023 were select-ed as study subjects.Group based on whether VA occurred during hospitalization,with 71 patients with VA as the observation group and 111 patients without VA as the control group.The levels of QTc,Tp-Tec,serum BNP and Gal-3 were detected and compared between two groups.The influencing factors of VA after AMI were analyzed by multivariate Logistic regression analysis,the predictive efficacy of QTc,Tp-Tec combine with serum BNP and Gal-3 on VA after AMI were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of QTc,Tp-Tec,serum BNP and Gal-3 in observation group were higher than those in control group(P＜0.05).Multi-variate Logistic regression analysis showed that elevated QTc,Tp-Tec,BNP and Gal-3 and double/multiple vascular lesions were risk factors for VA after AMI.ROC curve analysis showed that,the combined detection of QTc,Tp-Tec,BNP and Gal-3 had the best predic-tive efficacy for VA after AMI,with AUC of 0.864,sensitivity of 92.50％,specificity of 79.83％and Youden index of 0.723.Conclusion:The levels of QTc,Tp-Tec,BNP and Gal-3 in VA patients after AMI are increase,and are risk factors for VA after AMI.The combine detection of QTc,Tp-Tec,BNP and Gal-3 has a good predictive value for VA after AMI.
基金项目
山东省重点研发计划项目(2016ZRA01076)
NETL
NSTL
万方数据