论文部分内容阅读
目的探讨就诊时年龄、血压、心率、氨基末端脑钠肽前体(NT-pro BNP)等指标的联合应用在鉴别诊断射血分数(EF)降低型急性心力衰竭(AHFREF)和EF保留型急性心力衰竭(AHFPEF)中的价值。方法回顾性分析急性心力衰竭(AHF)患者就诊时年龄、性别、血压、心率、NT-pro BNP、微机血糖及1 d内心脏超声等指标。将AHF患者分为AHFREF组(EF<0.5)和AHFPEF组(EF≥0.5)。用二分类Logistic回归分析建立回归方程。根据接受者工作特征(ROC)曲线选择最适诊断截点。结果入选患者130例,年龄[M(P25,P75)]74.0(64.0,80.0)岁,男79例(60.8%),女51例(39.2%)。AHFREF组50例(38.5%),AHFPEF组80例(61.5%)。X1(NT-pro BNP)、X2(收缩压)、X3(舒张压)、X4(年龄)、X5(心率)进入回归方程P=1/[1+e-(-1.432+0.524X1-0.023X2+0.038X3-0.029X4+0.012X5)],最适诊断截点0.345,准确度为76.9%,灵敏度为84.0%,特异度为72.5%。结论联合应用就诊时年龄、血压、心率、NT-pro BNP对鉴别诊断AHFREF和AHFPEF有重要的参考价值。
Objective To explore the combination of age, blood pressure, heart rate and NT-proBNP in diagnosis of AHFREF and EF-preserved acute exacerbation Value in Heart Failure (AHFPEF). Methods Retrospective analysis of age, sex, blood pressure, heart rate, NT-pro BNP, micro-computer glucose, and intracardiac echocardiography within 1 d were performed in patients with acute heart failure (AHF). AHF patients were divided into AHFREF group (EF <0.5) and AHFPEF group (EF≥0.5). Logistic regression analysis was used to establish the regression equation. The most appropriate diagnostic cut-off point is selected based on the receiver operating characteristic (ROC) curve. Results A total of 130 patients were enrolled in this study. The age of the patients was 74.0 (64.0, 80.0) years old. There were 79 males (60.8%) and 51 females (39.2%). 50 cases (38.5%) in AHFREF group and 80 cases (61.5%) in AHFPEF group. X1 (NT-pro BNP), X2 (systolic blood pressure), X3 (diastolic blood pressure), X4 (age) and X5 (heart rate) entered the regression equation P = 1 / [1 + e - (- 1.432 + 0.524X1-0.023X2 +0.038X3-0.029X4 + 0.012X5)], the optimal diagnostic cut-off point was 0.345, the accuracy was 76.9%, the sensitivity was 84.0% and the specificity was 72.5%. Conclusions Age, blood pressure, heart rate and NT-pro BNP at the time of combined treatment have important reference value for differential diagnosis of AHFREF and AHFPEF.