急性冠状动脉综合征患者住院期间全因死亡的相关因素及心电图QRS-T夹角的预测价值分析

Prognostic value of correlation factors of all-cause death in patients with acute coronary syndrome and QRs-T angle of electrocardiogram

目的 分析急性冠状动脉综合征(ACS)患者住院期间全因死亡的危险因素及心电图QRST夹角的预测价值。方法 选定西安国际医学中心医院心电检查中心2020年12月至2022年12月接诊的120例ACS患者,将全因死亡作为患者住院期间主要终点事件,分为全因死亡组(10例)、非死亡组(110例),以回顾性调查分析法通过查阅病历、检查报告、问诊等方式收集患者个人信息,Logistic回归分析全因死亡的危险因素,绘制受试者工作特征曲线(ROC),分析QRS-T夹角预测全因死亡的灵敏度、特异度。结果心电图QRS-T夹角≥90°、左室射血分数(LVEF)降低、N末端B型利钠肽原(NT-proBNP)增高是造成ACS患者住院期间全因死亡的危险因素(P<0.05)。心电图QRS-T夹角预测ACS患者全因死亡的标准误(sx)是0.010,曲线下面积(AUC)是0.806,95%CI可信区间为(0.734,0.947),灵敏度是93.1%,特异度是90.8%。结论心电图QRS-T夹角≥90°、LVEF降低、NT-proBNP增高是ACS住院期间全因死亡的危险因素,心电图QRS-T夹角在预测ACS患者全因死亡方面灵敏度、特异度均较高。

Objective To analyze the risk factors of all-cause death in patients with acute coronary syndrome(ACS)during hospitalization and the predictive value of ECG QRS-T angle,Methods A total of 120 patients with ACS admitted to the ECG Examination Center of Xi'an International Medical Center Hospital from December 2020 to December 2022 were selected.All-cause death was regarded as the primary endpoint event.during hospitalization,and they were divided into all-cause death group(10 cases)and non-death group(110 cases).The personal information of patients was collected by means of consulting medical records,examination reports and consultation through retrospective investigation and analysis.The risk factors of all-cause death were analyzed by logistic regression,ROC curve was drawn,and the sensitivity and specificity of QRS-T Angle in predicting all-cause death was analyzed.Results ECG QRS-T Angle≥90°,reduced left ventricular ejection fraction(LVEF),and increased N-terminal B-type natriuretic peptide(NT-proBNP)were risk factors for all-cause death in patients with ACS during hospitalization(P<0.05).The standard error of ECG QRS-T Angle in predicting all-cause death of Acs patients was 0.010,AUC was 0.806,95%CI confidence interval was 0.734 to 0.947,sensitivity was 93.1%,specificity was 90.8%.Conclusion ECG QRs-T Angle≥90°,decreased LVEF and increased NT-proBNP are risk factors for all-cause death during hospitalization of ACS.Ecg QRS-T Angle has high sensitivity and specificity in predicting all-cause death of Acs patients.