军事医学2025，Vol.49Issue(4)：289-295,7.DOI:10.7644/j.issn.1674-9960.2025.04.007
D-二聚体联合Tei指数评估急性失代偿心力衰竭患者容量负荷的价值
Applicability of D-dimer combined with Tei index in assessing the volume load of patients with acute decompensated heart failure
叶智勇 1余贤兴 1蒋辉2
作者信息
- 1. 浙江省台州市中医院急诊科,浙江台州 318000
- 2. 台州市博爱医院内科,浙江台州 318000
- 折叠
摘要
Abstract
Objective To investigate the applicability of D-dimer levels combined with the Tei index in assessing the volume load in patients with acute decompensated heart failure(ADHF).Methods Two hundred patients admitted to the Emergency Department of Taizhou TCM Hospital between 2022 and 2023 were selected as the subjects,who were divided into a low volume load group(n=121)and a high volume load group(n=79)based on plasma volume indices.The clinical indicators and parameters of cardiac function of these subjects were compared.Multivariate Logistic regression analysis was used for identification of potential risk factors for elevated volume loads.A model for prediction of elevated volume loads was developed via Chi-square automatic interaction detection,followed by internal validation via Bootstrapping.Logistic regression analysis was used to study the interactions between D-dimer levels and Tei indices in assessing the volume loads of patients with ADHF.Results Multivariate regression analysis showed that age,Tei index,D-dimer levels and B type natriuretic peptide(BNP)were risk factors for high volume loads in ADHF patients.The decision tree model established had 14 nodes and 8 terminal nodes.Four explanatory variables including age,Tei index,D-dimer levels and BNP were screened out.The area under curve(AUC),sensitivity,specificity and prediction accuracy of the classification tree model were higher than those of the regression model.When D-dimer levels ≥1.16 and Tei index ≥0.65 interacted and co-existed,ADHF patients were at higher risk of developing high volume loads(OR=6.526,95％CI:2.439-7.183).The results of restricted cubic spline analysis pointed to nonlinear dose response relationships in the correlation strength of D-dimer levels,Tei index and volume loads.Conclusion There are interactions between D-dimer levels and Tei index,and the risk of high volume loads in ADHF patients is significantly increased when D-dimer levels are 1.16 or above and Tei index is 0.65 or above.关键词
D-二聚体/Tei指数/急性失代偿心力衰竭/容量负荷Key words
D-dimer/Tei index/acute decompensated heart failure/volume overload分类
临床医学引用本文复制引用
叶智勇,余贤兴,蒋辉..D-二聚体联合Tei指数评估急性失代偿心力衰竭患者容量负荷的价值[J].军事医学,2025,49(4):289-295,7.
