电子心力测量法对成人心力衰竭的诊断价值研究

打开文本图片集

【中图分类号】R541.6 【文献标志码】A

【AbstractObetiveToivestigatethalueoflectricalcardiometryEC）oinvasiemodyamictestingtehquedi agnosis ofheartfailure（HF）inadults.Methods：Aprospectivestudywasconductedamong theadultpatients whowere hospitalizedin DepartmentofCrdiologyheFirstAfiliatedHospitalofChongqingMedicalUniversityfromSeptemberO2 toMay24，andthe patientswhowerediagnosedwithHFwereenoledasHFgroup，hilethosehowereexcludedfromthecliicaldiagnosisofHFwere enroledascontrolgroup.Thetwogroupswerecomparedintermsof enerallinicaldataandrelatedparameters measuredbyECincludingstrokevlumeariation（SVV），systolictimeratioSTR）preejectionperiod（EP），ndexfcontractity（ION）- tion（VIC），ftvtriclarecti（LE）ndleftvntricarectifractio（VEF）.Auivaratelisticgesel establishedbytheforwardmethodwasusedtoinvestigatethefactorsassociatedwithHF.Thereceiveroperatingcharacteristic（ROC） curve wasplotedforthehemodynamicparameters measuredbyECinthediagnosisofHF，andtheareaunder theROCcurve（AUC wascalculated.Results：Atotalof239patientswereenrolled，with 126 in the HF group and 113 in the control group.Compared with thecontrol group，theHFgrouphadsignificantlyhigherSVV，STR， PEP，VIC，and age and significantly lower ICON，LVET，andLVEF （all P<0.001 ）.The multivariate logistic regression model establishedbytheforwardmethodshowedthatSTR（odds ratio⌊OR⌋= 1.199，95%CI=1.110-1.294，P<0.001），VIC（OR=1.176，95%CI=

1.090-1.269， P<0.001 ），and age（0R=1.068，95%CI=1.010-1.128， P<0.05 ）were positively correlated with HF，and ICON（OR=0.968， 95%CI=0.941-0.996，P<0.05） and LVEF（OR=0.854，95%CI=0.798-0.913， P<0.001 ）were negatively correlated with HF.The ROC curve analysis showed that STR，VIC，and ICON had an AUC of 0.887（ 95% CI=0.848-0.927），0.891（95%CI=0.851-0.932），and 0.718（95%CI=0.654-0.782），respectively，in the diagnosis of HF，with an optimal cut-off value of 37.5%， 19.5% ，and 49.3，respectively，a sensitivity of 91.3% 73.8% ，and 50.0% ，respectively，and a specificity of 61.4% ，93.8%，and 86.7%，respectively. Among theseindicators，STRcombinedwithVIChdanAUCofO94（95%CI=0.912-0.967）inthediagnosisofHF，withasensitivityof 83.3% andaspecificityof91.2%.Conclusion：TheECmethodcaneffctivelyassessthecardiacfunctional statusofadultpatients， and STR combined with VIC has some clinical value for the diagnosis of heart failure.

【Keywords】noninvasive hemodynamic testing;electrical cardiometry;heart failure

心力衰竭（heartfailure，HF）是一种复杂的临床综合征，具有病死率高、医疗费用高的特点，给全球公共卫生带来沉重负担[-2]。（剩余11661字）