静息心电图ST-T异常及应激性血糖升高比值与急性左心衰短期预后的相关性  

Resting electrocardiogram ST-T abnormality and stress hyperglycemia ratio are positively correlated with short-term prognosis of acute left heart failure

作　　者：王功旭 陈亮 李林辉[2] 陈宝 WANG Gongxu;CHEN Liang;LI Linhui;CHEN Bao(Department of Emergency,Affiliated Hospital of Xiangnan University,Chenzhou 423000,China;Department of Cardiology,Affiliated Hospital of Xiangnan University,Chenzhou 423000,China;Affiliated Hospital of Xiangnan University,Chenzhou 423000,China)

机构地区：[1]湘南学院附属医院急诊科,湖南郴州423000 [2]湘南学院附属医院心血管内科,湖南郴州423000 [3]湘南学院附属医院,湖南郴州423000

出　　处：《中国医学物理学杂志》2025年第4期505-509,共5页Chinese Journal of Medical Physics

基　　金：湖南省自然科学基金(2022JJ30938)。

摘　　要：目的:探讨静息心电图ST-T异常及应激性血糖升高比值(SHR)与急性左心衰(ALHF)短期预后的相关性。方法:收集125例ALHF患者的临床资料,根据发病30 d内预后情况分为预后良好组(n=59)、预后不良组(n=42)、死亡组(n=24)。收集3组静息心电图指征及入院即刻血糖、次日空腹糖化血红蛋白,计算SHR,分析静息心电图ST-T异常及SHR与ALHF短期预后的相关性。结果与结论:3组患者性别、血压等一般资料比较无统计学差异(P>0.05),但预后良好组年龄低于死亡组(P<0.05)。预后良好组静息心电图ST-T异常率、QRS波群时限、QTc间期均低于预后不良组和死亡组(P<0.05),且预后不良组低于死亡组(P<0.05)。预后良好组SHR低于预后不良组和死亡组(P<0.05),且预后不良组低于死亡组(P<0.05)。多因素Logistic回归分析显示,ST-T异常、QRS波群时限延长、QTc间期延长、SHR高值均为影响ALHF患者预后不良发生的独立危险因素(P<0.05)。静息心电图ST-T异常、SHR与ALHF短期预后均呈现显著正相关。Objective To investigate the correlations of resting electrocardiogram ST-T abnormality and stress hyperglycemia ratio(SHR)with short-term prognosis of acute left heart failure(ALHF).Methods The clinical data of 125 patients with ALHF were analyzed.According to the prognosis within 30 days after onset,the patients were divided into good prognosis group(n=59),poor prognosis group(n=42)and death group(n=24).The resting electrocardiogram indications,admission blood glucose and glycosylated hemoglobin at fasting on the next day were collected,and SHR was calculated for exploring the correlations of resting electrocardiogram ST-T abnormality and SHR with short-term prognosis of ALHF.Results and conclusion The differences in gender,blood pressure and other general data among 3 groups were trivial(P>0.05),but death group was at an older age as compared with good prognosis group(P<0.05).The resting electrocardiogram ST-T abnormality rate,QRS wave duration and QTc interval were lower/shorter in good prognosis group than in the other two group(P<0.05),and the above indicators were lower/shorter in poor prognosis group than in death group(P<0.05).Good prognosis group had the lowest SHR,followed by poor prognosis group and death group(P<0.05).Multivariate Logistic regression analysis revealed that ST-T abnormality,prolonged QRS wave duration,prolonged QTc interval and high SHR were independent risk factors for poor prognosis in ALHF patients(P<0.05).Resting electrocardiogram ST-T abnormality and SHR were significantly and positively correlated with ALHF short-term prognosis.

关 键 词：静息心电图 应激性血糖升高比值 急性左心衰 预后 相关性 

分 类 号：R541.6[医药卫生—心血管疾病]