作者：王富行，韩东建，代珊，张义，刘苗苗，庄沅松，沈德良

单位：

1.郑州大学第一附属医院心血管内科2.郑州大学医学科学院实验动物平台

Units：

1.Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China2.Laboratory Animal Center, Academy of Medical Science of Zhengzhou University, Zhengzhou 450000, China

关键词：

心力衰竭; 射血分数降低的心力衰竭; 心电图评分; 不良结局;

Keywords：

Heart failure; Heart failure with reduced ejection fraction; Electrocardiogram score; Adverse outcomes

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.030

Funds：

国家自然科学基金面上项目（82170271）； 河南省高层次人才特殊支持“中原千人计划”中原领军人才（ZYQR201912022）；

摘要：

目的 探讨心电图评分对射血分数降低的心力衰竭(HFrEF)患者发生不良结局的预测价值。方法选取2021年6—9月郑州大学第一附属医院收治的HFrEF患者169例。将心电图评分>2分的患者作为高风险组(n=93)，心电图评分≤2分的患者作为低风险组(n=76)。比较两组基线资料、不良结局发生情况。采用KaplanMeier法绘制生存曲线，生存曲线比较采用Log-rank检验。采用单因素、多因素Cox比例风险回归分析探讨HFrEF患者发生不良结局的影响因素；采用ROC曲线分析心电图评分对HFrEF患者发生不良结局的预测价值。结果 低风险组红细胞计数高于高风险组，N末端脑钠肽前体(NT-proBNP)低于高风险组(P<0.05)。低风险组累积不良结局发生率低于高风险组(χ2=46.390,P<0.001)。多因素Cox比例风险回归分析结果显示，NT-proBNP升高、心电图评分>2分是HFrEF患者发生不良结局的独立危险因素(P<0.05)。ROC曲线分析结果显示，心电图评分预测HFrEF患者发生不良结局的AUC为0.774[95%CI(0.698,0.843)]，最佳截断值为2.5分，灵敏度为72.4%，特异度为77.4%。结论 心电图评分是HFrEF患者发生不良结局的危险因素，其对HFrEF患者发生不良结局有一定预测价值。

Abstract：

Objective To investigate the predictive value of ECG score for adverse outcomes in patients with heartfailure with reduced ejection fraction (HFrEF) . Methods A total of 169 patients with HFrEF admitted to the First AffiliatedHospital of Zhengzhou University from June to September 2021 were selected. Patients with ECG score > 2 were classified ashigh risk group (n=93) , and patients with ECG score ≤ 2 were classified as low risk group (n=76) . Baseline data and adverseoutcomes were compared between the two groups. Kaplan-Meier method was used to draw survival curves, and Log-rank test wasused to compare survival curves. Univariate and multivariate Cox proportional risk regression analysis was used to investigate theinfluencing factors of adverse outcomes in HFrEF patients. ROC curve was used to investigate the predictive value of ECG scorefor adverse outcomes in HFrEF patients. Results The red blood cell count in the low risk group was higher than that in the highrisk group, and N-terminal pro-brain natriuretic peptide (NT-proBNP) was lower than that in the high risk group (P < 0.05) .The cumulative incidence of adverse outcomes of low risk group was lower than that of high risk group (χ2=46.390, P < 0.001) .Multivariate Cox proportional risk regression analysis showed that increased NT-proBNP and ECG score > 2 were independentrisk factors for adverse outcomes in HFrEF patients (P < 0.05) . ROC curve analysis results showed that the AUC of ECG scorein predicting adverse outcomes in HFrEF patients was 0.774 [95%CI (0.698, 0.843) ] , the optimal cut-off value was 2.5 points,the sensitivity was 72.4% , and the specificity was 77.4%. Conclusion ECG score is a risk factor for adverse outcome in HFrEFpatients, and it has certain predictive value for the occurrence of adverse outcomes in HFrEF patients

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