无创检测指标对心源性猝死预测的前瞻性和回顾性临床研究

The retrospective and prospective studies of non-invasive detection indicators for predicting the sudden cardiac death

目的 研究无创检测指标及指标间的优化组合对心脏性猝死的预测价值.方法 ①收集心脏性猝死和对照组病例各100例,对其超声左室射血分数（LVEF）,心电图QRS宽度、QT间期、校正QT间期（QTc）进行回顾性研究.②收集猝死高危和低危病例各50例的LVEF、心室晚电位（VLP）、心率变异性的SDNN指标、窦性心率震荡的心率起始（TO）和心率斜率（TS）等数据,随访1年,以心脏性猝死或室颤作为终点事件,对上述数据进行二分类Logistic多因素回归分析前瞻性研究.结果 经回顾和前瞻性研究、多因素回归分析发现,TS、SDNN、LVEF（〈35%）与心脏性猝死有相关性,检测指标LVEF（35%～40%）联合VLP、TO和TS对预测心脏性猝死有临床价值.结论 TS、LVEF（〈35%）、SDNN、LVEF（35%～40%）联合VLP预测心脏性猝死发生具有显著的临床意义.

Objective To investigate the clinical value of non-invasive prediction indicators of detection sudden cardiac death（SCD） by prospective and retrospective studies. Methods （1）The data of ultrasound left ventricular ejection fraction（LVEF）, ECG QRS width, QT interval, and corrected QT interval （QTc） were collected from 100 of SCD and their control group patients was analyzed retrospectively. （2）SCD or Ventricular Fibrillation （VF） in followed-up one year was the terminal event. The data of LVEF, VLP, SDNN, TO and TS was collected from 50 in high-risk of SCD and their control group patients.and was analyzed prospectively by the binary logistic regression statistical analysis. Results There were statistic significant different in TS, SDNN, LVEF, LVEF（35% -40%） co-VLP and TO combining TS of non-invasive prediction indicators of SCD by multivariate regression analysis in retrospective and prospective studies. Conclusion There are clinical significant value in TS, SDNN, LVEF, LVEF （35%-40%） co-VLP and TO combining TS for predicting SCD.