[1]施春晓,娄伦田,向征鸿,等.冠状动脉钙化积分与红细胞分布宽度对射血分数保留型心力衰竭患者不良预后的预测价值[J].陕西医学杂志,2023,52(7):842-846.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.015]
　SHI Chunxiao,LOU Luntian,XIANG Zhenghong,et al.Predictive value of coronary artery calcification score and red blood cell distribution width on poor prognosis of HFpEF patients[J].,2023,52(7):842-846.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.015]
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冠状动脉钙化积分与红细胞分布宽度对射血分数保留型心力衰竭患者不良预后的预测价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年7期
页码:
842-846
栏目:
临床研究
出版日期:
2023-07-05

文章信息/Info

Title:
Predictive value of coronary artery calcification score and red blood cell distribution width on poor prognosis of HFpEF patients
作者:
施春晓1; 娄伦田1; 向征鸿1; 章则陈2
(1.四川省第二中医医院检验科,四川 成都610014; 2.仙桃市第一人民医院医学检验科,湖北 仙桃 433099)
Author(s):
SHI Chunxiao; LOU Luntian; XIANG Zhenghong; ZHANG Zechen
(Department of Laboratory,Sichuan Second Hospital of Traditional Chinese Medicine,Chengdu 610014,China)
关键词:
射血分数保留型心衰;  冠状动脉钙化积分;  红细胞分布宽度;  不良预后;  预测敏感性;  预测特异性
Keywords:
Heart failure with preserved ejection fraction;  Coronary artery calcification fraction;  Red blood cell distribution width;  Poor prognosis;  Predictive sensitivity;  Predictive specificity
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7377.2023.07.015
文献标志码:
A
摘要:
目的:探讨通过计算机断层摄影(CT)分析冠状动脉钙化积分(CACS)联合红细胞分布宽度(RDW)对射血分数保留型心衰(HFpEF)患者不良预后发生的预测价值。方法: 本研究回顾性分析了诊断为HFpEF的患者,通过电话随访记录患者是否发生全因死亡及心源性死亡。根据中位数,由低-高将CACS分成三组(CACS为0、0～400及≥400),比较三组的基线资料均衡性; 单因素分析与HFpEF不良预后可能相关的指标; 为排除混杂因素,进行多因素COX回归分析,得出HFpEF患者不良预后的独立预测因子; 受试者工作特征曲线(ROC)分析RDW及CACS单独及联合对HFpEF患者不良预后的具体预测价值。结果: 本研究共收集268例HFpEF患者,其中19例失访,最终纳入249例,随访时间为(51.2±22.8)个月,期间共发生80 例全因死亡,其中61例心源性死亡。相关性分析显示RDW、CACS与HFpEF患者基线指标和实验室指标的相关性比较无统计学差异(均P>0.05); 多因素COX回归显示RDW及CACS 为HFpEF患者全因死亡发生风险的独立预测因子(均P<0.05); RDW及CACS为HFpEF患者心源性死亡发生风险的独立预测因子(均P<0.05)。ROC曲线分析显示CACS、RDW联合预测 HFpEF不良预后的敏感性、特异性及曲线下面积均高于各项单独预测。结论:RDW及CACS是HFpEF患者不良预后的强有力预测因子,两者联合预测价值更强。
Abstract:
Objective:To investigate the predictive value of coronary artery calcification score(CACS)combined with red blood cell distribution width(RDW)on poor prognosis of patients with heart failure with preserved ejection fraction(HFpEF).Methods:The patients with HFpEF were retrospectively analyzed.The occurrence of all-cause mortality and cardiac death by telephone follow-up were recorded.According to the median of CACS,the patients were divided into three groups(CACS =0,0 to 400 and ≥400).The balance of baseline data among the three groups was compared.Univariate analysis was used to analyze the indicators that may be related to the poor prognosis of HFpEF.In order to exclude confounding factors,multivariate COX regression analysis was performed to obtain the independent predictors of poor prognosis in HFpEF patients.ROC curve was used to analyze the predictive value of RDW and CACS alone or in combination for the poor prognosis of HFpEF patients.Results:A total of 248 patients with HFpEF were included in this study,and 19 cases were lost to follow-up.Finally,our study included 249 cases.The follow-up time was(51.2±22.8)months,during which 80 all-cause deaths occurred,including 61 cardiac deaths.Correlation analysis showed that RDW and CACS were not significantly correlated with baseline and laboratory parameters of HFpEF patients(all P>0.05).Multivariate COX regression showed that RDW and CACS were independent predictors of all-cause mortality in HFpEF patients(all P<0.05); RDW and CACS were independent predictors of cardiac death in HFpEF patients(all P<0.05).ROC curve analysis showed that the sensitivity,specificity and area under the curve of the combination of CACS and RDW in predicting the poor prognosis of HFpEF were higher than those of each individual prediction.Conclusion:RDW and CACS are powerful predictors for poor outcomes in patients with HFpEF,and the combination of two parameters had higher predictive value.

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备注/Memo

备注/Memo:
基金项目:四川省公益性科研院所基本科研项目(2022-4-715)
更新日期/Last Update: 2023-07-05