本文選題：急性心力衰竭 + 完全性右束支傳導阻滯��； 參考：《臨床心血管病雜志》2017年09期

【摘要】：目的:探討完全性右束支傳導阻滯(CRBBB)與急性心力衰竭(AHF)患者長期病死率之間的相關性。方法:入選2012-03-2015-02因AHF入住我院的患者346例,收集與分析入選者的臨床資料及入院時的相關檢驗及檢查結果,前瞻性隨訪所有患者18個月,其終點事件為全因死亡。根據(jù)終點事件將其分為死亡組和生存組。結果:(1)39例(11.3%)失訪,73例(23.8%)死亡;(2)完成隨訪的307例AHF患者中有35例(11.4%)合并CRBBB,其中生存組中有17例,而死亡組中18例(P0.01);(3)Kaplan-Meier分析后發(fā)現(xiàn)合并CRBBB的AHF患者死亡風險明顯高于無CRBBB的AHF患者(P0.01);(4)CRBBB用于預測AHF患者預后的特異度可達92.7%(95%CI88.6~95.7),敏感度為24.7%(95%CI 15.3~36.1);(5)COX逐步回歸分析(向前)顯示,合并CRBBB的AHF患者比無CRBBB的AHF患者死亡風險超過2倍(HR=3.912,95%CI 2.208~6.933)。結論:CRBBB對評估AHF患者長期預后有重要價值。
[Abstract]:Aim: to investigate the relationship between complete right bundle branch block (CRBBB) and long term mortality in patients with acute heart failure (AHF). Methods: a total of 346 patients admitted to our hospital for AHF from 2012-03-2015-02 were enrolled. The clinical data of the selected patients were collected and analyzed. All patients were prospectively followed up for 18 months. They were divided into death group and survival group according to the end event. Results among the 307 cases of AHF, 35 cases (11.4%) were complicated with AHF, including 17 cases in the survival group (17 cases in the survival group, 17 cases in the survival group). However, the mortality risk of AHF patients with CRBBB was significantly higher than that of AHF patients without CRBBB by Kaplan-Meier analysis. The specificity for predicting the prognosis of AHF patients was 92.7%, 95% CI 88.6% (95.7%), and the sensitivity was 24.7%(95%CI 15.33% 36.1X stepwise regression analysis (forward). The risk of death in AHF patients with CRBBB was more than 2 times higher than that in AHF patients without CRBBB. Conclusion it is valuable to evaluate the long-term prognosis of AHF patients.
【作者單位】： 南京醫(yī)科大學第一附屬醫(yī)院心臟科;
【基金】：國家科技支撐計劃課題(No:2011BAI11B08) 江蘇省六大人才高峰資助項目[No:WSN-031(IB15)]
【分類號】：R541.6

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