心电图指标结合BNP、SIRI对AMI患者的预后评估价值

Prognostic value of ECG indicators combined with BNP and SIRI in AMI patients

目的 分析研究心电图指标联合脑钠肽(BNP)、系统性炎症反应指数(SIRI)对急性心肌梗死患者(AMI)的预后评估价值。方法 选取2020年1月至2022年1月阜南县人民医院心内科收治的AMI患者作为研究对象,将其命名为AMI组(n=105),另选同期在本院的体检健康人员为对照组(n=60)。比较两组的心电图指标(SDNN、SDANN、RMSSD、PNN50)与血清BNP、SIRI水平;在患者出院后随访1年,以随访期间出现心血管不良事件及患者死亡为预后不良,采用多因素Logistic回归分析AMI患者预后不良的相关影响因素,并绘制ROC曲线分析心电图指标与血清BNP、SIRI水平对AMI患者预后不良的预测价值。结果 AMI组的SDNN、SDANN、RMSSD、PNN50均低于对照组,血清BNP、SIRI水平均高于对照组,差异均具有统计学意义(t=17.588、17.102、13.216、12.687、34.118、38.549,均P<0.05);多因素Logistic回归分析显示,有糖尿病史(OR=1.866)、有高血压病史(OR=1.902)、SDNN水平降低(OR=2.086)、SDANN水平降低(OR=2.104)、RMSSD水平降低(OR=2.121)、PNN50水平降低(OR=2.002)、BNP水平升高(OR=2.372)及SIRI水平升高(OR=1.784)均是AMI患者预后不良的独立危险因素(P<0.05);ROC曲线分析结果显示,SDNN、SDANN、RMSSD、PNN50、BNP、SIRI水平联合检测优于单一检测(P<0.05)。结论 心电图指标联合脑钠肽、系统性炎症反应指数对急性心肌梗死患者的预后具有一定的评估价值。

Objective To analyze the prognostic value of electrocardiogram(ECG)combined with BNP and systemic inflammatory response index(SIRI)in patients with acute myocardial infarction(AMI).Methods AMI patients admitted to the Department of Cardiology of Funan County Peoples Hospital from January 2020 to January 2022 were selected as the research objects and named as the AMI group(n=105),and healthy individuals in our hospital during the same period were selected as the control group(n=60).The ECG indexes[SDNN,SDANN,RMSSD,PNN50]and serum BNP and SIRI levels were compared between the two groups.The patients were followed up for 1 year after discharge,and the occurrence of cardio-vascular adverse events and patient death during the follow-up period was regarded as poor prognosis.Multivar-iate logistic regression was used to analyze the related influencing factors of poor prognosis in AMI patients,and the ROC curve was drawn to analyze the predictive value of ECG index,serum BNP and SIRI level on poor prognosis in AMI patients.Results The levels of SDNN,SDANN,RMSSD and PNN50 in the AMI group were lower than those in the control group,and the levels of serum BNP and SIRI were higher than those in the control group,the differences were statistically significant(t=17.588,17.102,13.216,12.687,34.118,38.549,P<0.05).Multivariate logistic regression analysis showed that the history of diabetes mellitus(OR=1.866),history of hypertension(OR=1.902),decreased SDNN level(OR=2.086),decreased SDANN level(OR=2.104),decreased RMSSD level(OR=2.121),decreased PNN50 level(OR=2.002),increased BNP level(OR=2.372)and increased SIRI level(OR=1.784)were independent risk factors for poor progno-sis in AMI patients(P<0.05).The ROC curve analysis results showed that the combined detection of SDNN,SDANN,RMSSD,PNN50,BNP,and SIRI levels was superior to a single detection(P<0.05).Conclu-sion The ECG indicators combined with brain natriuretic peptide and systemic inflammatory response index have a certain value in evaluating the prognosis of patients with acute myocardial infarction.