人类免疫缺陷病毒/获得性免疫缺陷综合征患者心电图异常情况及其影响因素分析  

Abnormalities of Electrocardiogram in HIV/AIDS Patients and Related Influencing Factors

作　　者：庞磊 邵宏华 蓝健 黄妹青[3] 杨雅云[1] 吴明真 冯润川[2] 吴文英 PANG Lei;SHAO Honghua;LAN Jian;HUANG Meiqing;YANG Yayun;WU Mingzhen;FENG Runchuan;WU Wenying(Department of Electrocardiology,HIV/AIDS Clinical Treatment Center of Guangxi(Nanning)the Fourth People's Hospital of Nanning,Nanning 530023,China;Department of General Internal Medicine,HIV/AIDS Clinical Treatment Center of Guangxi(Nanning)the Fourth People's Hospital of Nanning,Nanning 530023,China;the First Department of Infection,HIV/AIDS Clinical Treatment Center of Guangxi(Nanning)the Fourth People's Hospital of Nanning,Nanning 530023,China)

机构地区：[1]南宁市第四人民医院[广西艾滋病临床治疗中心(南宁)]心电诊疗科,南宁530023 [2]南宁市第四人民医院[广西艾滋病临床治疗中心(南宁)]综合内科,南宁530023 [3]南宁市第四人民医院[广西艾滋病临床治疗中心(南宁)]感染一病区,南宁530023

出　　处：《临床误诊误治》2023年第5期88-92,共5页Clinical Misdiagnosis & Mistherapy

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20210101)。

摘　　要：目的探讨人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者心电图异常情况及其影响因素。方法选取2021年7—12月收治的HIV/AIDS 546例,均行心电图检查,统计心电图异常情况,采用多因素Logistic回归分析探讨HIV/AIDS患者心电图异常影响因素,并建立预测模型,绘制受试者工作特征(ROC)曲线分析模型预测价值。结果HIV/AIDS患者心电图异常率为67.03%。多因素Logistic回归分析结果显示,有吸烟史、肺部感染、CD4+<200μL、CD8+<500μL、高效抗反转录病毒治疗(HAART)、HAART时间≥2年是HIV/AIDS患者心电图异常的独立危险因素(P<0.01)。HIV/AIDS患者心电图异常影响因素多因素Logistic回归模型评价显示模型建立具有统计学意义(P<0.01),回归方程系数差异有统计学意义(P<0.01),模型拟合效果较好(P>0.05)。多因素Logistic回归模型对HIV/AIDS患者心电图异常预测价值的ROC曲线分析结果显示,曲线下面积为0.851,95%CI(0.817,0.880)。随机抽取1例进行个体预测,结果显示在预测准确率为77.29%的条件下,该患者发生心电图异常。结论HIV/AIDS患者心电图异常受诸多因素影响,如吸烟史、肺部感染、CD4+<200μL、CD8+<500μL等,根据影响因素构建多因素Logistic回归模型对HIV/AIDS患者心电图异常具有可靠预测价值。Objective To investigate the abnormal electrocardiogram and its influencing factors in human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)patients.Methods A total of 546 patients with HIV/AIDS admitted from July to February 2021 were selected,all of whom underwent electrocardiogram examination.The abnormal electrocardiogram was statistically analyzed,and the influencing factors of abnormal electrocardiogram in HIV/AIDS patients were discussed using multivariate Logistic regression analysis,and the prediction model was established.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of the model.Results The abnormal rate of electrocardiogram in HIV/AIDS patients was 67.03%.Multivariate Logistic regression analysis showed that smoking history,lung infection,CD4+<200μL,CD8+<500μL,high-potency antiretroviral therapy(HAART),duration of HAART≥2 years were independent risk factors for ECG abnormalities in HIV/AIDS patients(P<0.01).The multivariate Logistic regression model evaluation of the influencing factors of ECG abnormality in HIV/AIDS patients showed that the model establishment had statistical significance(P<0.01),that the coefficient difference of regression equation had statistical significance(P<0.01),and that the model fitting effect was good(P>0.05).The ROC curve analysis of the predictive value of ECG abnormalities in HIV/AIDS patients by multivariate Logistic regression model showed that the area under the ROC curve(AUC)was 0.851,95%CI(0.817,0.880).One case was randomly selected for individual prediction,and the results showed that under the condition of prediction accuracy of 77.29%,the patient developed abnormal electrocardiogram.Conclusion ECG abnormalities in HIV/AIDS patients are affected by various factors,such as smoking history,lung infection,CD4+<200μL,and CD8+<500μL.The construction of multivariate Logistic regression model according to the influencing factors has reliable value in predicting ECG abnormalities in HIV/AIDS patients.

关 键 词：获得性免疫缺陷综合征 人类免疫缺陷病毒 心电描记术 异常 CD4+ CD8+ 高效抗反转录病毒治疗 LOGISTIC模型 

分 类 号：R512.91[医药卫生—内科学]