增强型体外反搏治疗老年心力衰竭患者疗效的相关因素及与Lp-PLA2的相关性分析  

Curative effect-related factors and correlation between them and lipoprotein phospholipase A2 in elderly patients with heart failure treated withenhanced external counter pulsation

作　　者：张倩 韩建妙[1] 李丛然 师志芳[1] 闫士然 张莉忠 Zhang Qian;Han Jianmiao;Li Congran;Shi Zhifang;Yan Shiran;Zhang Lizhong(Second Department of Geriatrics,Third Hospital of Shijiazhuang City,Shijiazhuang 050000,China;不详)

机构地区：[1]石家庄市第三医院老年医学二科,石家庄050000 [2]石家庄市第三医院心功能科,石家庄050000

出　　处：《中国循证心血管医学杂志》2024年第12期1475-1478,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：石家庄市科学技术研究与发展计划(211460413)。

摘　　要：目的探讨增强型体外反搏(EECP)治疗老年心力衰竭患者疗效的相关因素,并分析其与脂蛋白磷脂酶A2(Lp-PLA2)的关联性。方法选取2022年6月至2024年6月于石家庄市第三医院行EECP治疗的297例老年心力衰竭患者的临床资料,根据治疗效果分为有效组(n=267)和无效组(n=30),收集患者基础资料及血清Lp-PLA2等临床资料,绘制受试者工作特征(ROC)曲线分析治疗前血清Lp-PLA2水平对EECP疗效的预测价值,采用Logistic回归分析影响疗效的相关因素。结果297例老年心力衰竭患者经EECP治疗1疗程后,显效77例,有效190例,无效30例,临床治疗总有效率为89.90%。经EECP治疗后,有效组患者血清LP-PLA2水平显著低于无效组,差异有统计学意义(P<0.05)。ROC曲线分析:血清Lp-PLA2预测老年心力衰竭患者EECP疗效的曲线下面积为0.836(95%CI:0.789~0.876,P<0.05),截断值为226.15ng/ml,敏感度为76.67%,特异度为80.52%。Logistic回归分析:NYHA分级较高、心律失常、营养不良及高水平Lp-PLA2是老年心力衰竭患者疗效的独立影响因素(P<0.001)。结论EECP治疗老年心力衰竭患者的疗效显著,但需注意NYHA分级较高、心律失常、营养不良及高水平LP-PLA2均可能是影响疗效的相关因素,临床需重点关注危险因素患者的预后。Objective To investigate the factors related to curative effect of enhanced external counter pulsation(EECP),and analyze correlation between EECP and lipoprotein phospholipase A2(Lp-PLA2)in elderly patients with heart failure(HF).Methods The elderly HF patients treated with EECP(n=297)were chosen from the Third Hospital of Shijiazhuang City from June 2022 to June 2024.All patients were divided,according to curative effect,into effective group(n=267)and ineffective group(n=30).The baseline materials and serum Lp-PLA2 level were collected in 2 groups.The predictive value of serum Lp-PLA2 level before treatment to curative effect of EECP was reviews by using ROC curve.The relative factors affecting curative effect were analyzed by using Logistic regression analysis.Results In 297 elderly HF patients treated with EECP for one course,there were 77 with excellent effectiveness,190 with effectiveness and 30 with ineffectiveness,and the total effective rate was 89.90%.The level of serum Lp-PLA2 was significantly lower in effective group than that in ineffective group after EECP treatment(P<0.05).The results of ROC curve analysis showed that in prediction of curative effect of EECP,AUC of serum Lp-PLA2 was 0.836(95%CI:0.789~0.876,P<0.05),cut-off value was 226.15 ng/ml,sensitivity was 76.67%and specificity was 80.52%.The results of Logistic regression analysis showed that higher grade of NYHA,arrhythmia,malnutrition and higherserum Lp-PLA2 level were independent factors affecting curative effect of EECP(P<0.001).Conclusion EECP has a significant curative effect in elderly HF patients,while higher grade of NYHA,arrhythmia,malnutrition and higherserum Lp-PLA2 level may be factors affecting curative effect,and close attentions should be paid to the prognosis of patients with above risk factors.

关 键 词：增强型体外反搏 心力衰竭 脂蛋白磷脂酶A2 

分 类 号：R654.2[医药卫生—外科学]