超声心动图参数联合系统性炎症反应指数对急性心力衰竭患者短期预后的预测价值  

Predictive value of ultrasonic cardiogram parameters combined with systemic inflammatory response index on short-term prognosis in patients with acute heart failure

作　　者：尹玉莲 戴朝晖[1] 李利[2] 金静[1] YIN Yu-lian;DAI Zhao-hui;LI Li(Department of Cardiology,Changsha Fourth Hospital,Changsha 410006,China)

机构地区：[1]长沙市第四医院心血管内科,长沙410006 [2]长沙市第四医院超声科,长沙410006

出　　处：《放射学实践》2022年第9期1166-1170,共5页Radiologic Practice

基　　金：长沙市科学技术局指导性课题(kzd2001097)。

摘　　要：目的:探讨超声心动图参数联合系统性炎症反应指数(SIRI)对急性心力衰竭(AHF)患者短期预后的预测价值。方法:纳入120例AHF患者作为研究对象,采用飞利浦IU Elite型超声心动仪采集所有患者的左心室收缩期末容积(LVESV)、左心室舒张期末容积(LVEDV)、左心室射血分数(LVEF)、二尖瓣舒张早期血流峰值速度与二尖瓣环舒张早期运动峰值速度比值(E/E')和左心室整体纵向应变(GLS)水平,记录SIRI数值,根据美国纽约心脏病协会心功能分级标准对心功能水平进行分级。出院后随访6个月,根据患者预后分为终点事件组和无终点事件组。结果:52例(43.33%)患者发生了终点事件(终点事件组),68例(56.67%)患者未发生终点事件(无终点事件组)。终点事件组与无终点事件组患者的年龄、心功能分级比较差异有统计学意义(P<0.05)。终点事件组患者的LVEF显著低于无终点事件组,GLS绝对值显著低于无终点事件组,SIRI显著高于无终点事件组,差异有统计学意义(P<0.05);心功能分级II级患者的LVEF显著高于Ⅲ~Ⅳ级患者,GLS绝对值显著低于Ⅲ~Ⅳ级患者,SIRI显著低于Ⅲ~Ⅳ级患者,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,LVEF、GLS和SIRI是AHF患者短期预后不良的独立危险因素(P<0.05)。ROC曲线分析结果显示LVEF、GLS联合SIRI预测AHF患者短期预后不良的AUC为0.950(95%CI=0.914~0.986,P<0.001),敏感度和特异度分别为88.5%和92.6%。结论:LVEF、GLS、SIRI与AHF患者的短期预后有关,具有一定临床应用价值。Objective:To investigate the predictive value of ultrasonic cardiogram parameters combined with systemic inflammatory response index(SIRI)on the short-term prognosis in patients with acute heart failure(AHF).Methods:A total of 120 patients with AHF were included in this study,and the left ventricular end-systolic volume(LVESV),Left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)levels,the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity(E/E')and left ventricular longitudinal strain(GLS)level were obtained from Philips IU Elite type ultrasonic cardiogram equipment.SIRI values were recorded as well.The cardiac function level was graded according to the New York Heart Association cardiac function grading standard.The patients were followed up for 6 months after discharge,and divided into end-point event group and non-end-point event group according to their prognosis.Results:End-point events occurred in 52(43.33%)patients(end-point event group),and non-end-point events occurred in 68(56.67%)patients(non-end-point event group).There were statistically significant differences in age and cardiac function classification between the two groups(P<0.05).The LVEF of patients in the end-point event group was significantly lower than that in the non-end-point event group,the absolute value of GLS of patients in the end-point event group was significantly lower than that in the non-end-point event group,and the SIRI of patients in the end-point event group was significantly higher than that in the non-end-point event group,with statistically significant differences(P<0.05).The LVEF of patients with cardiac function gradeⅡwas significantly higher than that of patients with cardiac function gradeⅢ-Ⅳ,the absolute value of GLS of patients with cardiac function gradeⅡwas significantly lower than that of patients with cardiac function gradeⅢ-Ⅳ,and the SIRI of patients with cardiac function gradeⅡwas significantly lower than that of patients w

关 键 词：急性心力衰竭 超声心动图 左心室射血分数 整体纵向应变 系统性炎症反应指数 预后 

分 类 号：R541.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]