Peguero-Lo Presti指数对射血分数保留型心力衰竭的诊断价值  

Diagnostic value of Peguero-Lo Presti index on heart failure with preserved ejection fraction

作　　者：陈乐昀 游濠乐 郑炜平[2] Leyun;YOU Haole;ZHENG Weiping(College of Chinese Integrative Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350122;Provincial Clinical Medical College,Fujian Medical University,Fuzhou Fujian 350001,China)

机构地区：[1]福建中医药大学中西医结合学院,福建福州350122 [2]福建医科大学省立临床医学院,福建福州350001

出　　处：《实用心电学杂志》2024年第2期122-127,共6页Journal of Practical Electrocardiology

基　　金：福建省自然科学基金资助项目(2021J01401)。

摘　　要：目的探讨Peguero-Lo Presti指数对射血分数保留型心力衰竭(heart failure with preserved ejection fraction,HFpEF)的诊断价值。方法收集于福建医科大学省立临床医学院心内科住院的有心力衰竭(简称心衰)临床症状,且心电图、心脏超声、生化、N末端B型利钠肽原等临床资料完整的患者,依据急慢性心衰诊断和治疗指南推荐的HFA-PEFF评分标准,纳入HFpEF组120例(男60例、女60例),将同期住院无心衰患者100例(男56例、女44例)设为对照组。比较两组的基线资料特征,在标准12导联心电图上,分别计算和分析Peguero-Lo Presti指数、Cornell乘积指数和Romhilt-Estes评分,并比较3个指标诊断HFpEF的ROC曲线下面积、敏感性与特异性。结果与对照组相比,HFpEF组性别、年龄、糖尿病比例、冠心病、高密度脂蛋白胆固醇、血清肌酐差异均无统计学意义(P>0.05);高血压、低密度脂蛋白胆固醇、高尿酸血症的比例显著升高(P<0.05)。在男性亚组中,Peguero-Lo Presti指数ROC曲线下面积[0.84(0.76,0.90)]高于Cornell乘积指数[0.70(0.61,0.78)]和Romhilt-Estes评分[0.62(0.53,0.71)](P均<0.05);Peguero-Lo Presti指数的敏感性(66.67%)高于Cornell乘积指数(48.33%)和Romhilt-Estes评分(36.57%),且差异有统计学意义(P均<0.05);特异性差异无统计学意义。在女性亚组中,Peguero-Lo Presti指数ROC曲线下面积[0.77(0.69,0.85)]高于Cornell乘积指数[0.68(0.58,0.77)]和Romhilt-Estes评分[0.57(0.47,0.66)](P均<0.05);敏感性(68.33%)高于Romhilt-Estes评分(26.67%),且差异有统计学意义(P<0.01);特异性差异无统计学意义。结论心电图Peguero-Lo Presti指数对HFpEF具有较高的敏感性和特异性,且检查方法便捷,临床上可作为HFpEF的辅助诊断和筛查指标。Objective To explore the diagnostic value of Peguero-Lo Presti index on heart failure with preserved ejection fraction(HFpEF).Methods We selected patients with clinical symptoms of heart failure(HF)who had been hospitalized in the Department of Cardiology of Provincial Clinical Medical College,Fujian Medical University;their clinical data were complete,including ECGs,cardiac ultrasound,biochemistry,and NT-proBNP.Based on the HFA-PEFF score standard recommended by the Guidelines for the diagnosis and treatment of acute and chronic HF,120 patients were enrolled in the HFpEF group(60 males and 60 females)while 100 cases without HF were divided into the control group(56 males and 44 females).The baseline data characteristics were compared between the two groups.Peguero-Lo Presti index,Cornell product index,and Romhilt-Estes score were separately calculated and analyzed in the standard 12-lead ECGs.We compared the area under the ROC curve,sensitivity and specificity of the above three indicators for diagnosing HFpEF.Results Compared with the control group,there was no statistically significant difference in the baseline data such as sex,age,diabetes proportion,coronary heart disease,high-density lipoprotein cholesterol,and serum creatinine in the HFpEF group(P>0.05);the proportion of hypertension,low-density lipoprotein cholesterol and hyperuricemia increased(P<0.05).In the male subgroup,the area under the ROC curve of the Peguero-Lo Presti index was 0.84(0.76,0.90),which was higher than that of the Cornell product index[0.70(0.61,0.78)]and that of the Romhilt-Estes score[0.62(0.53,0.71)](all P<0.05).The sensitivity of the Peguero-Lo Presti index was 66.67%,which was higher than that of the Romhilt-Estes score(36.57%)and that of the Cornell product index(48.33%),with statistically significant differences(all P<0.05)while the difference of specificity was not statistically significant.In the female subgroup,the area under the ROC curve of the Peguero-Lo Presti index was 0.77(0.69,0.85),which was higher than that of the

关 键 词：Peguero-Lo Presti指数 射血分数保留型心力衰竭 慢性心力衰竭 左心室肥厚 

分 类 号：R541.9[医药卫生—心血管疾病]