摘要
目的 探讨经皮冠状动脉介入治疗(PCI)手术前后QRS-T夹角变化值对老年急性冠脉综合征(ACS)患者主要不良心血管事件(MACE)的预测效能。方法 回顾性选择2021年3月至2022年3月于丽水市人民医院接受PCI术的ACS患者208例。根据在随访期间有无发生MACE分为观察组(52例)和对照组(156例)。检测并比较两组患者手术前后QRS-T夹角、手术前后QRS-T夹角变化值、术前Gensini评分。采用多因素logistic回归分析术后MACE发生的危险因素。采用ROC曲线评价QRS-T夹角变化值、Gensini评分对老年ACS患者MACE的预测效能。分析QRS-T夹角变化值与Gensini评分的相关性。结果 观察组QRS-T夹角变化值低于对照组,Gensini评分高于对照组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果表明QRS-T夹角变化值和Gensini评分是MACE发生的独立因素(均P<0.05)。在预测MACE上,QRS-T夹角变化值的AUC低于Gensini评分,特异度高于Gensini评分(r=0.367,P<0.001)。QRS-T夹角变化值与Gensini评分呈负相关(r=-0.367,P<0.001)。结论 老年ACS患者PCI手术前后QRS-T夹角变化对MACE有较好的预测效能。
Objective To explore the predictive power in QRS-T angle changes before and after percutaneous coronary intervention(PCI)for major adverse cardiovascular events(MACE)in elderly patients with acute coronary syndrome(ACS).Methods A total of 208 ACS patients who underwent PCI from Mar 2021 to Mar 2022 in Lishui People's Hospital were selected.According to the occurrence of MACE within follow-up,the patients were divided into an observation group(52 cases)and a control group(156 cases).QRS-T angle and the change values in QRS-T angle before and after PCI,and the preoperative Gensini score were measured and compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for postoperative MACE.ROC curve was used to evaluate the predictive power of the change values in QRS-T angle and Gensini score for MACE in elderly patients with ACS.The correlation between the change value in QRS-T angle and Gensini score was analyzed.Results The change value in QRS-T angle was significantly lower,while Gensini score was significantly higher in the observation group than in the control group(both P<0.05).Multivariate logistic regression analysis showed that the change value of QRS-T angle and Gensini score were independent factors for MACE(all P<0.05).In predicting MACE,the AUC of QRS-T angle change value was significantly lower than Gensini score,while the specificity was significantly higher than Gensini score.The change value in QRS-T angle was negatively related to Gensini score(r=-0.367,P<0.001).Conclusion The change in QRS-T angle before and after PCI in elderly patients with ACS has a better predictive power for MACE.
作者
杨展玲
樊梁军
吴晓卯
YANG Zhanling;FAN Liangjun;WU Xiaomao(Department of ECG,Lishui People's Hospital,Lishui 323000,China;不详)
出处
《心电与循环》
2024年第3期252-255,260,共5页
Journal of Electrocardiology and Circulation
