摘要
目的 探讨血清学指标联合超声心动图参数对房间隔缺损(ASD)合并肺动脉高压(PAH)的预测价值及临床意义.方法 选取为2021年1月至2023年1月在新疆医科大学第一附属医院经彩色多普勒超声心动图检查确诊为房间隔缺损患者293例,根据ASD患者是否合并PAH分为不伴PAH组(n=176例)和伴PAH组(n=117例).分析两组患者一般临床资料、血清学指标、超声心动图参数,采用二元logistic回归分析得到ASD合并PAH的独立危险因素,采用受试者特征工作曲线(ROC曲线)下面积评估血清学指标和超声心动图参数单独及联合检测对ASD合并PAH的预测价值.结果 与不伴PAH组相比较,伴PAH组患者体重指数(BMI)、红细胞压积(HCT)、红细胞分布宽度、N末端脑钠肽前体(NT-proBNP)、尿酸、尿酸/肌酐比值、白蛋白、缺损直径、左心房内径、右心室流出道内径、右心房内径、右心室内径、三尖瓣反流压差、肺动脉收缩压水平差异具有统计学意义(均P＜0.05).多因素二元logistic回归分析结果显示,HCT、红细胞分布宽度、尿酸/肌酐比值、三尖瓣反流压差均是ASD合并PAH的独立危险因素.ROC曲线显示,HCT、红细胞分布宽度、尿酸/肌酐比值、三尖瓣反流压差单独检测及其联合检测的ROC曲线下面积分别为0.604、0.584、0.592、0.633和0.715.结论 HCT、红细胞分布宽度、尿酸/肌酐比值和三尖瓣反流压差单独及其联合检测对ASD合并PAH预测均具有一定的价值,且联合检测的预测效果最好.
Abstract
Objective To the predictive value and clinical significance of serological indexes combined with echocardiographic parameters for atrial septal defect(ASD)merging pulmonary artery hypertension(PAH).Methods A total of 293 patients with ASD diagnosed by color Doppler echocardiography in the First Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were selected.According to whether the patients were complicated by PAH,they were divided into the group without PAH(n=176 cases)and group with PAH(n=1 17 cases).The general clinical data,serological indicators and echocardiographic parameters of the two groups were analyzed.Binary logistic regression analysis was used to obtain the independent risk factors for ASD mergeing PAH.The area under the receiver operating characteristic curve(ROC curve)was used to assess the predictive value that serological indexes and echocardiographic parameters alone and in combination detection for ASD mergeing PAH.Results There were statistically significant differences in the body mass index(BMI),hematocrit(HCT),red blood cell distribution width,N-terminal pro-brain natriuretic peptide(NT-proBNP),uric acid,uric acid/creatinine ratio,albumin,defect diameter,internal diameter of the left atrium,right ventricular outflow tract inner diameter,internal diameter of the right atrium,right ventricular internal dimension,tricuspid valve reflux pressure difference and pulmonary artery systolic pressure between the 2 groups(all P＜0.05).Multifactorial binary logistic regression analysis showed that HCT,red blood cell distribution width,uric acid/creatinine ratio and tricuspid valve reflux pressure difference were the independent risk factors for the ASD mergeing PAH.The area under ROC curve of HCT,red blood cell distribution width,uric acid/creatinine ratio,tricuspid valve reflux pressure difference and combined detection were 0.604,0.584,0.592,0.633 and 0.715,respectively.Conclusion Serological indexes HCT,red cell distribution width,uric acid/creatinine ratio and the echocardiographic parameters tricuspid reflux pressure difference alone and combined detection are of certain value for the prediction of ASD mergeing PAH,but the combined detection has better prediction effect.
维普
万方数据