QTc间期早期预测重型颅脑损伤患者预后的价值  

The value of QTc interval in early prediction of prognosis in patients with severe craniocerebral injury

作　　者：杨雪林[1] 潘群婕[1] 陈徐斌 Yang Xuelin

机构地区：[1]浙江省丽水市中心医院,323000 [2]浙江省丽水市人民医院,323000

出　　处：《浙江临床医学》2020年第9期1262-1264,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨QTc间期在早期预测重型颅脑损伤(STBI)患者预后中的临床价值.方法选取2017年6月至2019年6月急诊重症监护室STBI?94例患者,收集患者的急性生理与慢性健康(APACHEⅡ)评分、格拉斯哥昏迷指数(GCS)评分、神经元烯醇化酶(NSE)、心肌酶谱指标及心电图(ECG)资料.评估QTc间期在早期预测STBI患者预后中的临床价值.结果94例患者中,死亡组QTc间期延长患者例数高于存活组,差异有统计学意义(P<0.05).QTc间期与APACHEⅡ评分、GCS评分及NSE存在相关性(r=0.819、-0.690、0.633,P<0.001).ROC曲线分析QTc间期预测患者死亡率,其曲线下面积0.840(95%?CI=0.699~0.981).结论QTc间期与APACHEⅡ评分、GCS评分具有较好的相关性,在预测STBI患者死亡率方面是一个较好的指标,简单快捷且有效,为临床医师在早期预测STBI患者预后中提供较可靠的依据.Objetive To investigte the clinical value of QTc interval in carly predicting the prognosis of patents with severe traumatic brain injury(STBI).Methods 94 patients with STBI admitted to the emergency intensive care unit of our hospital from June 2017 to June 2019 were selected as the study subjects.The acute physiology and chronic health(APACHE Ⅱ)score,Glasgow Coma Scale(GCS)score,Neuron Specific Enolase(NSE),myocardial zymogram and Elctrocardiogram(ECG)data for cach patient were ollcted.The clinical value of QTc interval in predicting the prognosis of STBI was evaluated at an early stage.Results Of the 94 patients enrolled in the study,the number of patients with prolonged QTc interval in the death group was higher than that in the survival group,and the diference was satistically significant(P<0.05).The QTc interval was well correlated with the APACHE Ⅱ score,GCS score and NSE.Ther values were 0.819,-0.690 and 0.633,respectively,and the Pvalues were<0.001.The ROC curve was used to predict the mortality rate of patients with QTc interval,and the area under the curve was 0.840(95%CI=0.699-0.981).Conclusion The QTc interval has a good correlation with the APACHE II score and GCS score.It is a good indicator for predicting mortality in STBI.It is simple,fast and efecctive,and can provide clinicians with a early reliable predictor of prognosis with STBI.

关 键 词：重型颅脑损伤 QTC间期 心肌酶 早期预测 预后 

分 类 号：R54[医药卫生—心血管疾病]