超声心动图、外周血氨基端前脑钠素及心电图联合检测对不同左室射血分数冠心病心力衰竭患者的临床诊断价值  

Clinical diagnostic value of echocardiography and peripheral blood N-terminal pro brain natriuretic peptide combined with electrocardiogram in patients with different left ventricular ejection fraction and coronary heart disease heart failure

作　　者：华琴 张博成 陈娟 张宝钧 丁海波 HUA Qin;ZHANG Bocheng;CHEN Juan;ZHANG Baojun;DING Haibo(Department of Functional,Xinyu Hospital of Traditional Chinese Medicine,Jiangxi Province,Xinyu338000,China)

机构地区：[1]江西省新余市中医院功能科,江西新余338000

出　　处：《中国当代医药》2023年第10期93-96,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220212268)。

摘　　要：目的探究超声心动图、外周血氨基端前脑钠素(NT-proBNP)及心电图联合检测对不同左室射血分数(LVEF)冠心病心力衰竭(CHD-HF)患者的临床诊断价值。方法选取新余市中医院2021年8月至2022年6月收治的80例CHD-HF患者作为研究对象,根据左室射血分数(LVEF)进行分组,LVEF<35%纳入A组(40例),LVEF 35%~49%纳入B组(40例)。对两组患者进行超声心动图、NT-proBNP及心电图检测,比较两组患者检测结果,并根据logistic结果绘制ROC曲线,评估三者联合检测的临床诊断价值。结果A组左室舒张末期内径(LVEDD)、左房内径(LAD)、NT-proBNP水平均高于B组,差异有统计学意义(P<0.05)。A组QRS波时限、QTc间期均高于B组,差异有统计学意义(P<0.05)。QRS电压值低于B组,差异有统计学意义(P<0.05)。ROC结果显示超声心动图、外周血NT-proBNP、心电图单独检测及三者联合检测不同LVEF CHD-HF患者的AUC值分别为0.699、0.706、0.711、0.849,三者联合诊断价值高于单一诊断,差异有统计学意义(P<0.05)。结论LVEF<35%和LVEF 35%~49%的CHD-HF患者超声心动图指标、NT-proBNP水平、心电图指标差异显著,三者联合检测可以提高不同LVEF CHD-HF患者的临床诊断价值。Objective To explore the clinical diagnostic value of echocardiography and peripheral blood N-terminal pro brain natriuretic peptide(NT-proBNP)combined with electrocardiogram in patients with different left ventricular ejection fraction(LVEF)and coronary heart disease heart failure(CHD-HF).Methods A total of 80 patients with CHD-HF admitted to Xinyu Hospital of Traditional Chinese Medicine from August 2021 to June 2022 were included in this study.According to LVEF,the patients were divided into group A(LVEF<35%,40 cases)and group B(LVEF of 35%-49%,40 cases).The echocardiography results,NT-proBNP and electrocardiograms of the two groups were compared between the two groups.Based on logistic results,ROC curve was used to evaluate the clinical diagnostic value of combination of the three.Results The left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)and NT-proBNP level in group A were higher than those in group B,the differences were statistically significant(P<0.05).The duration of QRS wave and QTc interval in group A were longer than those in group B,the differences were statistically significant(P<0.05),while QRS voltage was lower than that in group B,the difference was statistically significant(P<0.05).ROC curve analysis showed that the AUC values of echocardiography,peripheral blood NT-proBNP,electrocardiogram alone and in combination to diagnose patients with different LVEF and CHD-HF were 0.699,0.706,0.711 and 0.849 respectively.The diagnostic value of combination of the three was higher than that of single diagnosis,the difference was statistically significant(P<0.05).Conclusion There are significant differences in echocardiography indexes,NT-proBNP level and electrocardiogram indexes in patients with different LVEF(<35%,35%-49%)and CHD-HF.Combined detection of the three can improve the clinical diagnostic value of different LVEF CHD-HF.

关 键 词：冠心病 心力衰竭 心电图 超声心动图 氨基端前脑钠素 

分 类 号：R541.4[医药卫生—心血管疾病]