心电图参数联合血浆NT-proBNP水平对慢性心力衰竭患者预后的评估价值OACSTPCD

Objective:To explore the value of electrocardiogram parameters combined with plasma N-terminal pro-brain natri-uretic peptide(NT-proBNP)level in evaluating the prognosis of patients with chronic heart failure(CHF).Methods:108 patients with CHF were selected as the research subjects.They were divided into MACE group(n=30)and good prognosis group(n=78)accord-ing to the occurrence of cardiovascular adverse events(MACE)within 12 months of follow-up.The relevant data of two groups were col-lected and compared,including general data,left ventricular ejection fraction(LVEF),biochemical indicators[total cholesterol(TC),Low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),white blood cell count(WBC),plasma N-termi-nal precursor brain natriuretic peptide(NT-proBNP)]and electrocardiogram parameters(QRS wave duration,frontal QRS-T angle).Multiple Logistic regression analysis was used to identify the risk factors for MACE in CHF,the predictive value of relevant indicators on MACE was analyzed by Receiver Operating Characteristic(ROC)curves.Results:Compared with the good prognosis group,the MACE group had older age,lower LVEF,higher NYHA classification,QRS wave duration,frontal QRS-T angle and plasma NT-proB-NP level(P＜0.05).Multivariate Logistic regression analysis showed that NYHA classification(OR=1.137),LVEF(OR=1.335),QRS wave duration(OR=1.228),frontal QRS-T angle(OR=1.200)and NT-proBNP(OR=1.081)were independent risk factors for MACE in CHF patients(P＜0.05).ROC curve analysis showed that QRS duration,frontal QRS-T angle and NT-proBNP could predict the occurrence of MACE in CHF(P＜0.05).The area under the curve(AUC)was 0.658,0.924 and 0.842,respectively.The combination of the three had the highest predictive efficacy(AUC=0.959),and the sensitivity and specificity were90.00%and 93.59%,respectively(P＜0.05).Conclusion:Long QRS duration,large frontal QRS-T angle and high plasma NT-proBNP level are independent risk factors for MACE in CHF patients.All three can predict poor prognosis of patients,and the combination of the three has the best predictive efficacy.