肺心病患者心功能与24 h动态心电图相关性及其对病情预后价值判断的研究  

Study on the Correlation between Heart Function and 24-hour Dynamic Electrocardiogram in Patients with Cor Pulmonale and Its Prognostic Value

作　　者：高丽霞 蔡培伟[2] 余海鹏[3] GAO Lixia;CAI Peiwei;YU Haipeng(Electrocardiography Room,the First Affiliated Hospital of Shantou University Medical College,Shantou,Guangdong Province,515041 China;Echocardiography Room,the First Affiliated Hospital of Shantou University Medical College,Shantou,Guangdong Province,515041 China;Department of Internal Medicine,the First Affiliated Hospital of Shantou University Medical College,Shantou,Guangdong Province,515041 China)

机构地区：[1]广东省汕头大学医学院第一附属医院心电图室,广东汕头515041 [2]广东省汕头大学医学院第一附属医院超声心动图室,广东汕头515041 [3]广东省汕头大学医学院第一附属医院内科,广东汕头515041

出　　处：《世界复合医学》2022年第11期62-65,共4页World Journal of Complex Medicine

基　　金：汕头市科技计划医疗卫生类别项目(191217165268663)。

摘　　要：目的分析肺心病患者心功能与24 h动态心电图相关性及其对病情预后的判断价值。方法选取2019年11月—2021年10月广东省汕头大学医学院第一附属医院收治的100例肺心病患者。所有患者进行心脏超声检查与24 h动态心电图检查。以4周为评价时间段,采用纽约心脏病协会(NYHA)评级方法评估患者预后,并按NYHA评级结果将患者分为预后良好组(71例)与预后差组(29例)。比较预后良好组和预后差组间心脏超声和24 h动态心电图各项指标差异;采用Cox回归模型评价心功能和动态心电图各项指标对肺心病预后的预测价值。结果预后良好组RAT(45.42±4.10)mm、RAL(52.87±5.61)mm、RAA(20.58±6.32)mm比预后差组均更低,LVEF(34.45±6.42)%、RMSSD(22.36±3.84)ms、SDNN(57.28±13.19)ms、SDANN(56.25±16.78)ms比预后差组均高,差异有统计学意义(t=3.025、2.331、2.468、2.916、2.700、2.686、2.109,P<0.05)。RAT、RAL、RAA、LVEF、RMSSD、SDNN、SDANN对肺心病预后具有一定预测价值(P<0.05)。结论肺心病患者心功能与24 h动态心电图指标存在相关性,监测心功能指标与心电图指标可以评估患者病情,预测患者预后情况。Objective To explore and analyze the correlation between heart function and 24-hour dynamic electrocardiogram in patients with cor pulmonale and its prognostic value.Methods 100 patients with cor pulmonale admitted to the First Affiliated Hospital of Shantou University Medical College from November 2019 to October 2021 were selected.All patients were examined by echocardiography and 24 h dynamic electrocardiogram.The prognosis of the patients was evaluated with NYHA rating method in the evaluation period of 4 weeks,and the patients were divided into good prognosis group(71 cases)and poor prognosis group(29 cases)according to the NYHA rating results.The differences of cardiac ultrasound and 24 h dynamic electrocardiogram between the good prognosis group and the poor prognosis group were compared;Cox regression model was used to evaluate the prognostic value of cardiac function and dynamic electrocardiogram in patients with cor pulmonale.Results RAT(45.42±4.10)mm,RAL(52.87±5.61)mm,and RAA(20.58±6.32)mm in the good prognosis group were lower than those in the poor prognosis group,and LVEF(34.45±6.42)%,RMSSD(22.36±3.84)ms,SDNN(57.28±13.19)ms,and SDANN(56.25±16.78)ms were higher than those in the poor prognosis group,the difference was statistically significant(t=3.025,2.331,2.468,2.916,2.700,2.686,2.109,P<0.05).RAT,RAL,RAA,LVEF,RMSSD,SDNN,SDANN had some predictive value for prognosis of pulmonary heart disease(P<0.05).Conclusion There is a correlation between cardiac function and 24-hour dynamic ECG indexes in patients with pulmonary heart disease,and monitoring cardiac function indexes and ECG indexes can assess patients'condition and predict their prognosis.

关 键 词：肺心病 24 h动态心电图 心功能 预后 相关性 

分 类 号：R445[医药卫生—影像医学与核医学]