老年妇科肿瘤患者术后并发心衰的多因素分析  

Multiple factors in evaluating postoperative heart failure in elderly female patients with gynecological tumor

作　　者：王楠 张若溪[2] 侯静波[2] 董玲 孟胜楠 WANG Nan ZHANG Ruo-xi HOU Jing-bo DONG Ling MENG Sheng-nan(Department of Obstetrics and Gynecology, Hospital of Traditional Chinese Medicine of Qiqihar, Qiqihar 161000？Heilongjiang, China Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086,Heilongjiang, China)

机构地区：[1]齐齐哈尔市中医医院妇产科，齐齐哈尔 161000 [2]哈尔滨医科大学附属第二医院心内科，哈尔滨 150086

出　　处：《中国临床医学》2016年第6期785-789,共5页Chinese Journal of Clinical Medicine

基　　金：国家自然科学青年基金(30700765)~~

摘　　要：目的:评价多个生物学指标在老年女性妇科肿瘤术后并发心衰的预测作用。方法:采用回顾性研究,纳入416例老年妇科肿瘤患者,均接受外科手术治疗。根据心功能不全NYHA分级,将接受手术的患者分为心衰组和无心衰组。患者术前均接受体检、实验室检查、心电图监测、心脏彩超监测及妇科术前评估,术后再次行心脏彩超评价心功能。选取白细胞计数(WBC)、心电图碎裂QRS波(fQRS)、血清肌钙蛋白I(TnI)及氨基末端脑钠肽前体(NT-proBNP)等作为预测心功能的评价指标。结果:fQRS在心衰组发生率明显高于非心衰组,差异有统计学意义(P<0.05);心衰组WBC、TnI及NT-proBNP含量明显高于非心衰组,差异有统计学意义(P<0.05);联合多个生物学标志物预测性诊断老年女性妇科肿瘤术后并发心衰的敏感度为96.2%、特异度为85.4%。结论:联合检测多个生物学标志物可用于预测老年女性妇科肿瘤术后并发心衰,操作方法简易、预测结果有效。Objective ： To investigate the predictive effects of multiple biomarkers on heart failure in elderly femalepatients with gynecologic tumor after surgery. Methods ： This retrospective study included 416 elderly female patients withgynecologic tumor after surgical treatment. Patients were divided into the heart failure group and the non-heart-failure groupaccording to the NYHA classification of cardiac insufficiency. All patients underwent physical examination, laboratoryexamination, ECG, heart color Doppler sonography and preoperative evaluation of gynecology before operation, and the heartfunction was evaluated again by heart color Doppler sonography after operation White blood cell count （ W BC ）,electrocardiogram fragmented QRS complex （ fQ R S ）, serum cardiac troponin I （T n l） and N-terminal pro brain natriureticpeptide （NT-proBNP） were selected as evaluation indexes for predicting cardiac function Results： The appearance of fQRS inheart failure group was significantly higher than that in non-heart-failure group, and the difference was statistically significant（P〈〇. 05）. The heart failure group had significantly higher WBC, T n l, and NT-proBNP levels than the non-heart-failuregroup, and the differences were statistically significant （P〈C〇. 05）. The sensitivity of the combination of multiple biomarkers inpredicting postoperative heart failure in elderly female with gynecological tumor was 96. 2 % , and the specificity was 85. 4% .Conclusions ： The combination of multiple biomarkers can be used to predict postoperative heart failure in elderly female withgynecologic tumor with simple operation methods and effective prediction results.

关 键 词：妇科肿瘤 老年女性 术后 心衰 

分 类 号：R730.6[医药卫生—肿瘤]