心电图Q-T间期联合超声心动图对肺动脉高压的诊断价值及其与疾病严重程度的相关性  

The diagnostic value of Q-T interphase electrocardiogram combined with echocardiography in pulmonary hypertension and its correlation with disease severity

作　　者：张杰[1] 李长栓 秦博[3] 薛静[3] Zhang Jie;Li Changshuan;Qin Bo;Xue Jing(Department of Electrocardiogram,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471003,China;不详)

机构地区：[1]河南科技大学第一附属医院心电图室,洛阳471003 [2]洛阳市第三人民医院胸心外科,洛阳471002 [3]河南科技大学第一附属医院超声科,洛阳471003

出　　处：《中国循证心血管医学杂志》2024年第2期149-152,158,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190563)。

摘　　要：目的探讨心电图Q-T间期联合超声心动图对肺动脉高压的诊断价值及其与疾病严重程度的相关性。方法回顾性分析2020年1月至2023年1月于河南科技大学第一附属医院80例肺动脉高压患者的临床资料(肺动脉高压组),根据右心导管测得平均肺动脉压力(mPAP)将病情严重程度划分为轻度(25~35 mmHg)、中度(36~45 mmHg)、重度(>45 mmHg)。选取同期80例健康体检者作为对照组。两组均行心电图、超声心动图检查,比较心率矫正的Q-T间期(Q-Tc)、肺动脉收缩压(PASP)变化。以多因素Logistic回归分析法分析Q-Tc、PASP与肺动脉高压发生及病情严重程度的关系。以受试者工作特征(ROC)曲线分析Q-Tc、PASP单独及联合检测对肺动脉高压的诊断价值。结果与对照组比较,肺动脉高压组Q-Tc、PASP升高(P<0.05)。肺动脉高压组内Q-Tc、PASP比较,轻度低于中度、重度,中度低于重度(P<0.05)。多因素Logistic回归分析显示,Q-Tc、PASP是肺动脉高压发生及病情严重程度的重要影响因素(P<0.05)。ROC曲线显示,Q-Tc、PASP检测对肺动脉高压具有一定诊断价值,联合检测时诊断价值更高,敏感性为81.25%,特异性为77.50%,ROC曲线下面积为0.897。结论心电图Q-Tc联合超声心动图检查对肺动脉高压的诊断价值较高,且与疾病严重程度密切相关。Objective To investigate the diagnostic value of Q-T interphase electrocardiogram combined with echocardiography in pulmonary hypertension and its correlation with disease severity.Methods Clinical data of 80 patients with pulmonary hypertension in the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to January 2023(pulmonary hypertension group)were retrospectively analyzed.Based on mean pulmonary arterial pressure(mPAP)determined by the right cardiac catheter,the severity of the disease was classified as mild(25~35 mmHg),moderate(36~45 mmHg),and severe(>45 mmHg).Eighty healthy subjects in the same period were selected as a control group.Ecg and echocardiography were performed in both groups,and the changes in corrected Q-T interval(Q-Tc)and Pulmonary artery systolic pressure(PASP)were compared.Multivariate Logistic regression analysis was used to analyze the relationship between Q-Tc,PASP,and the occurrence and severity of pulmonary hypertension.The diagnostic value of Q-Tc and PASP alone and combined in pulmonary hypertension was analyzed by the receiver operating characteristic(ROC)curve.Results Compared with the control group,Q-Tc and PASP in the pulmonary hypertension group were increased(P<0.05).The comparison of Q-Tc and PASP in the pulmonary arterial hypertension group was lower than moderate and severe,and moderate was lower than severe(P<0.05).Multivariate Logistic regression analysis showed that Q-Tc and PASP were important factors affecting the occurrence and severity of pulmonary hypertension(P<0.05).ROC curve showed that Q-Tc and PASP detection had certain diagnostic value for pulmonary hypertension,and the combined detection had higher diagnostic values.The sensitivity was 81.25%,the specificity was 77.50%,and the area under the ROC curve was 0.897.Conclusion Electrocardiogram Q-Tc combined with echocardiography has high diagnostic values in pulmonary hypertension and is closely related to the severity of the disease.

关 键 词：肺动脉高压 心电图 超声心动图 诊断 

分 类 号：R543.2[医药卫生—心血管疾病]