心电图及相关指标预测CPHD患者住院期间死亡的临床研究  

Clinical Study on Predicting In-Hospital Mortality in CPHD Patients Using Electrocardiogram and Related Indicators

作　　者：周天[1,2,3] 向祖金 李颖 Zhou Tian;Xiang Zujin;Li Ying(Department of Electrocardiogram,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Hubei Key Laboratory of Ischemic Cardiovascular Disease,Yichang 443003,China;Hubei Provincial Clinical Research Center for Ischemic Cardiovascular Disease,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]心电诊断科,湖北宜昌443003 [2]缺血性心血管病湖北省重点实验室,湖北宜昌443003 [3]湖北省缺血性心血管疾病临床医学研究中心,湖北宜昌443003

出　　处：《巴楚医学》2025年第1期43-48,共6页Bachu Medical Journal

基　　金：中央引导地方科技发展专项基金项目(2022BGE237);宜昌市医疗卫生研究项目(A24-2-005)。

摘　　要：目的:探讨慢性肺源性心脏病(CPHD)患者住院期间死亡的独立危险因素。方法:收集2021年10月—2024年4月于宜昌市中心人民医院收治的CPHD患者152例,根据患者住院期间是否死亡分为死亡组(n=33)和存活组(n=119)。收集两组患者临床资料,进行单因素及多因素Logistic回归分析CPHD患者住院期间死亡的独立影响因素。结果:多因素Logistic结果显示,QRS-T夹角>90°(OR=1.026,95%CI:1.006,1.047)、Tp-Te间期>100 ms(OR=1.075,95%CI:1.009,1.145)、NT-proBNP>300 pg/mL(OR=1.083,95%CI:1.010,1.146)及肺动脉收缩压>35 mmHg(OR=1.085,95%CI:1.017,1.157)是CPHD患者住院期间死亡的危险因素(均P<0.05)。结果显示,QRS-T夹角>90°、Tp-Te间期>100 ms、NT-proBNP>300 pg/mL、肺动脉收缩压>35 mmHg及四者联合预测CPHD患者发生住院期间死亡的曲线下面积(AUC)分别是0.871、0.844、0.901、0.864及0.941。结论:QRS-T夹角>90°、Tp-Te间期>100 ms、NT-proBNP>300 pg/mL、肺动脉收缩压>35 mmHg是CPHD患者发生住院期间死亡的独立危险因素。Objective:To explore the independent risk factors for in-hospital mortality in patients with chronic pulmonary heart disease(CPHD).Methods:A total of 152 CPHD patients admitted to Yichang Central People's Hospital from October 2021 to April 2024 were collected and divided into death group(n=33)and survival group(n=119)according to whether the patients died during hospitalization.Clinical data of the two groups were collected,and univariate and multivariate logistic regression analysis was performed to analyze the independent influencing factors of in-hospital death of CPHD patients.Results:Multivariate logistic results showed that the angle of QRS-T was>90°(OR=1.026,95%CI:1.006,1.047)and the interval of Tp-Te was>100 ms(OR=1.075,95%CI:1.009,1.145),NT-proBNP>300 pg/mL(OR=1.083,95%CI:1.010,1.146)and pulmonary artery systolic blood pressure>35 mmHg(OR=1.085,95%CI:1.017,1.157)were risk factors for in-hospital death in CPHD patients(all P<0.05).The area under the curve(AUC)of QRS-T Angle>90°,Tp-Te interval>100 ms,NT-proBNP>300 pg/mL,pulmonary artery systolic blood pressure>35 mmHg and the combined prediction of CPHD patients for in-hospital death were 0.871,0.844,0.901,0.864 and 0.941,respectively.Conclusion:QRS-T Angle>90°,Tp-Te interval>100 ms,NT-proBNP>300 pg/mL,pulmonary artery systolic blood pressure>35 mmHg are independent risk factors for in-hospital death in CPHD patients.

关 键 词：QRS-T夹角 TP-TE间期 慢性肺源性心脏病 

分 类 号：R541.5[医药卫生—心血管疾病]