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| 体表心电图QRS-T夹角联合血清NT-proBNP、Melatonin、galectin-3预测射血分数保留心力衰竭患者预后的临床研究 |
| A clinical study of surface electrocardiogram QRS-T Angle combined with serum NT-proBNP, Melatonin, galectin-3 to predict the prognosis of patients with heart failure with preserved ejection fraction |
| 投稿时间：2023-03-13 修订日期：2023-03-13 |
| DOI： |
| 中文关键词: 射血分数保留心力衰竭 心电图 QRS-T夹角 N末端B型利钠肽原 褪黑素 半乳糖凝集素-3 |
| 英文关键词: Heart failure with preserved ejection fraction Electrocardiogram QRS-T Angle N-terminal B-type natriuretic peptide Melatonin Galectin-3 |
| 基金项目:湖北省科技计划项目（编号：2020CFB660） |
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| 中文摘要: |
| 目的 探讨体表心电图QRS-T夹角联合血清N末端B型利钠肽原（NT-proBNP）、褪黑素（Melatonin）、半乳糖凝集素-3（galectin-3）预测射血分数保留心力衰竭（HFpEF）患者预后的关系。方法 选择2020年1月至2022年1月武汉市第三医院心内科收治的156例HFpEF患者，入院当日行体表心电图检查，记录QRS-T夹角，检测血清NT-proBNP、Melatonin、galectin-3水平，出院后随访至2022年6月，根据是否发生不良心血管事件分为预后不良组和预后良好组。多因素Logistic回归分析影响HFpEF患者预后的因素，受试者工作特征曲线（ROC）分析QRS-T夹角联合血清NT-proBNP、Melatonin、galectin-3预测HFpEF患者预后的价值。结果 预后不良组QRS-T夹角大于预后良好组、血清NT-proBNP、galectin-3水平高于预后良好组，血清Melatonin水平低于预后良好组（P＜0.05）。QRS-T夹角增大、NT-proBNP、galectin-3升高是HFpEF患者预后不良的危险因素（P＜0.05），Melatonin升高是保护因素（P＜0.05）。联合四项指标预测HFpEF患者预后不良的曲线下面积为0.899，高于单独预测。结论 QRS-T夹角增大，血清NT-proBNP、galectin-3水平升高，血清Melatonin水平降低与HFpEF预后不良有关，联合四项指标有助于预测HFpEF预后。 |
| 英文摘要: |
| Objective To investigate the relationship between body surface ECG qrs-t angle and serum levels of N-terminal pro-B-type natriuretic peptide (NT proBNP), melatonin, and galectin-3 in predicting outcomes in patients with heart failure with preserved ejection fraction (HFPEF).Methods 156 cases of patients with HFpEF who were admitted to the Department of Cardiology of Wuhan Third Hospital from January 2020 to January 2022 were selected. Surface electrocardiogram examinations were performed on admission day, QRS-T Angle was recorded, serum NT-proBNP, Melatonin and galectin-3 levels were detected, and follow-up was conducted after discharge until June 2022. They were divided into poor prognosis group and good prognosis group according to the occurrence of adverse cardiovascular events. Multiple Logistic regression was used to analyze the prognostic factors of patients with HFpEF, and receiver operating characteristic curve (ROC) was used to analyze the value of QRS-T Angle combined with serum NT-proBNP, galectin-3 in predicting the prognosis of patients with HFpEF. Results The QRS-T Angle in the poor prognosis group was larger than that in the good prognosis group, the serum NT-proBNP and galectin-3 levels were higher than those in the good prognosis group, and serum Melatonin level was lower than that in the good prognosis group (P＜0.05). Enlarged QRS-T Angle, elevated NT-proBNP, galectin-3 were risk factors for poor prognosis in patients with HFpEF (P＜0.05), and elevated Melatonin was a protective factor (P＜0.05). The area under curve of combining the four indicators to predict poor prognosis of patients with HFpEF was 0.899, which was higher than that predicted by alone. Conclusion Enlarged QRS-T Angle, elevated serum NT-proBNP and galectin-3 levels, and decreased serum Melatonin level are associated with poor prognosis of HFpEF, and the combination of four indicators can help predict prognosis of HFpEF. |
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