摘要
Abstract
Objective To investigate the predictive value of frontal QRS-T angle for the severity of hypertriglyceridemic pancreatitis(HTGP).Methods A retrospective analysis was conducted on 137 patients with HTGP.Based on the frontal QRS-T angle,these patients were divided into two groups:≤90° group(n=82)and>90° group(n=55).Clinical data collected included patients'clinical characteristics,electrocardiogram within 2 hours of admission,hematological parameters,biochemical indexes,serum triglyceride(TG)levels,interleukin-6(IL-6),high-sensitivity cardiac troponin T(hs-cTnT),body mass index(BMI),etc.The follow-up endpoints were the need for ICU treatment and clinical severity grading of HTGP.Results Compared with the≤90° group,the>90° group had significantly higher heart rate,BMI,TG and IL-6 levels,ICU admission rate,and proportion of severe cases(all P<0.05).Logistic regression analysis identified the frontal QRS-T angle(OR=2.127,95%CI 1.178-3.840,P=0.012)and TG level(OR=1.687,95%CI 1.057-2.693,P=0.028)as independent risk factors for requiring ICU treatment in HTGP patients.The frontal QRS-T angle(OR=3.608,95%CI 1.792-7.263,P<0.05)and IL-6 level(OR=5.821,95%CI 2.280-14.865,P<0.05)were independent risk factors for clinical severity of HTGP.ROC curve analysis showed that the area under the curve(AUC)for predicting the need for ICU treatment was 0.765(95%CI 0.669-0.862)for the frontal QRS-T angle and 0.710(95%CI 0.613-0.807)for TG level.The optimal cutoff value for the frontal QRS-T angle was 70.5°(Youden index=0.505,sensitivity=86.1%,specificity=64.4%).For predicting moderately-severe to severe HTGP,the AUC value was 0.881(95%CI 0.825-0.938)for the frontal QRS-T angle and 0.891(95%CI 0.836-0.946)for IL-6 level,with an optimal cutoff value of 78.0°for the frontal QRS-T angle(Youden index=0.671,sensitivity=85.2%,specificity=81.9%).Conclusion HTGP patients with a frontal QRS-T angle>90° have higher ICU admission rates and proportion of severe cases.The frontal QRS-T angle and serum IL-6 level during the early inflammatory phase could serve as predictive indicators for the clinical severity of HTGP.关键词
额面QRS-T夹角/甘油三酯/高甘油三酯血症性胰腺炎/严重程度Key words
frontal QRS-T angle/triglyceride/hypertriglyceridemic pancreatitis/severity分类
医药卫生
