| 摘要: |
| 目的 探讨动态心电图T波变异性对急性冠脉综合征（ACS）患者快速性心律失常风险的预测价值。方法 以湖州市中心医院2022年3月至2024年3月收治的268例ACS患者为研究对象。入院后根据有无发生快速性心律失常分为发生组和未发生组。对比两组患者一般资料和动态心电图相关指标。采用多因素Logistic回归分析快速性心律失常发生的预测因素，绘制ROC曲线并计算曲线下面积（AUC）分析动态心电图T波变异性对快速性心律失常发生风险的预测价值。营养指标对谵妄发生风险的预测价值。结果 入院48小时内，268例ACS患者发生快速性心律失常45例，发生率为16.79%，未发生223例。单变量分析中发生组TIMI分级为1级例数显著多于未发生组（P值均<0.05）；发生组hs-CRP、NLR、Hcy水平高于未发生组（P值均<0.05）；发生组pNN50、Max TAV、Max TAV均高于未发生组（P<0.05）；多因素Logistic回归分析示hs-CRP（OR=32.924，95%CI：2.950~367.421）、NLR（OR=6.838，95%CI：2.152~21.722）、Max TAV（OR=1.064，95%CI：1.040~1.088）、Mean TAV（OR=1.127，95%CI：1.062~1.196）是快速性心律失常发生的危险因素，pNN50（OR=0.343，95%CI：0.199~0.590）是快速性心律失常发生的独立保护因素（P<0.05）；hs-CRP、Max TAV、Mean TAV、NLR以及pNN50对快速性心律失常发生具有较高的诊断价值。结论 hs-CRP、NLR、Hcy、pNN50、Max TAV、Mean TAV均是ACS患者发生快速性心律失常的相关因素，且动态心电图指标对ACS患者快速性心律失常的发生具有较高的预测价值。 |
| 关键词: 动态心电图 T波变异性 急性冠脉综合征 快速性心律失常 预测价值 |
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| Predictive value of T-wave variability of dynamic electrocardiogram on arrhythmia risk in patients with acute coronary syndrome |
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Ji Yuehua, Yu Ziheng
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Huzhou Central Hospital
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| Abstract: |
| Objective To explore the predictive value of T-wave variability of dynamic electrocardiogram on the risk of arrhythmia in patients with acute coronary syndrome (ACS). Methods A total of 268 patients with ACS admitted to Huzhou Central Hospital from March 2022 to March 2024 were selected as the research subjects. After admission, the patients were divided into the occurrence group and the non-occurrence group based on whether tachyarrhythmia occurred or not. The general information and related indicators of ambulatory electrocardiogram of the two groups of patients were compared. Multivariate Logistic regression was used to analyze the predictive factors of tachyarrhythmia. The ROC curve was plotted and the area under the curve (AUC) was calculated to analyze the predictive value of dynamic electrocardiogram T-wave variability for the risk of tachyarrhythmia. The predictive value of nutritional indicators for the risk of delirium occurrence. Results Within 48 hours after admission, 45 cases of 268 ACS patients developed arrhythmia, the incidence rate was 16.79%, and 223 cases did not occur. In univariate analysis, the number of cases with TIMI grade 1 in the occurrence group was significantly higher than that in the non-occurrence group (P<0.05). The levels of hs-CRP, NLR and Hcy in the occurrence group were higher than those in the non-occurrence group (P<0.05). PNN50, Max TAV and Max TAV in the occurrence group were higher than those in the non-occurrence group (P<0.05). Multivariate Logistic regression analysis showed that hs-CRP(OR=32.924,95%CI:2.950~367.421),NLR(OR=6.838, 95%CI:2.152~21.722) and Max TAV(OR=1.064, 95% CI). 95%CI:1.062~1.196) is a risk factor for arrhythmia, and pNN50(OR=0.343,95%CI:0.199~0.590) is an independent protective factor for arrhythmia (P<0.05). Hs-CRP, Max TAV, Mean TAV, NLR and pNN50 have high diagnostic value for arrhythmia. Conclusion hs-CRP, NLR, Hcy, pNN50, Max TAV and Mean TAV are all related factors of arrhythmia in ACS patients, and dynamic electrocardiogram indexes have high predictive value for arrhythmia in ACS patients. |
| Key words: dynamic electrocardiogram T wave variability Acute coronary syndrome Arrhythmia Predicted value |