无创预警指标对急性冠脉综合征患者猝死的预测价值  

The Predictive Value of Noninvasive Early Warning Indicators For Sudden Death in Patients with Acute Coronary Syndrome

作　　者：李爱英[1] 魏芳晶[1] 任润梅[1] 于赛华[1] 韩伟[1] 关宏[1] LI Ai-ying;WEI Fang-jing;REN Run-mei;YU Sai-hua;HAN Wei;GUAN Hong(Cardiovascular Dept Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010050 China)

机构地区：[1]内蒙古医科大学附属医院心血管内科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2021年第3期261-264,共4页Inner Mongolia Medical Journal

基　　金：内蒙古自然科学重点项目(编号:NJZZ18099)。

摘　　要：目的探讨连续心率减速力(DRs)联合其他预警指标对急性冠脉综合征(ACS)患者猝死的预测价值。方法选取2019~2020年在我院住院的ACS患者共150例为观察组,50例健康人为对照组。比较两组的DRs、窦性心率震荡、T波电交替。对DRs危险分层进行比较。对猝死的预测价值进行评估。结果(1)从对照组到实验组,预警指标明显异常。(2)冠脉病变3支组与1支组比较中高危患者增加,有统计学意义(P<0.05)。(3)发现DRs的阴性预测价值最高,指标联合对猝死风险的预测特异度、准确度明显提高。结论病情越严重,DRs危险分层越高,猝死预警指标越异常。DRs识别猝死低危患者价值更高,与其他指标联合对于准确筛选猝死高危患者价值更高。Objective To investigate the predictive value of heart rate deceleration runs(DRs)and other noninvasive early warning indicators for sudden death in patients with acute coronary syndrome(ACS).Methods A total of 150 ACS patients in our hospital from 2019 to 2020 were selected as the observation group,50 healthy people were selected as the control group.DRs、microvolt T-wave alternanc(MTWA)and heart rate turbulence(HRT)of the two groups were compared.Risk stratification comparisons were performed based on DRs results.The predictive value for sudden death was assessed.Results(1)From the normal control group to the observation group,the warning indicators were obviously abnormal.(2)There was a significant difference in medium or high-risk patients between 3-vessel coronary artery disease group and 1-vessel coronary artery disease group(P<0.05).(3)DRs was found to have the highest negative predictive value,The specificity and accuracy of the indicators combination for the prediction of sudden death risk were significantly improved.Conclusion The more severe the illness,the higher the DRs risk stratification,and the more abnormal the sudden death warning indicators.DRs has a higher value in identifying low-risk patients with sudden death,Combined with other indicators,the value of accurate screening of patients at high risk of sudden death is higher.

关 键 词：连续心率减速力 窦性心律震荡 T波电交替 急性冠脉综合征 猝死 

分 类 号：R541.4[医药卫生—心血管疾病]