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目的探讨心电图监测结合脑钠素(BNP)对急性左心衰(ALHF)老年患者预后的应用价值。方法对128例ALHF急性发作后6 h内及24、72 h血浆BNP进行检测,并行常规心电图检查。根据患者出院时的状态分为预后理想组(60例)、预后不佳组(45例)及死亡组(23例)。结果预后理想组急性发作后24、72 h血浆BNP、QRS波时限以及QTc间期的下降均较预后不佳组及死亡组明显(均P<0.05),而死亡组QRS波时限、QTc间期呈延长趋势。多因素Logistic回归分析结果显示BNP和QRS波、QTc间期是影响患者预后的独立危险因素。结论连续多个时点动态监测血浆BNP和心电图的变化特征,对评价老年ALHF患者的预后及死亡具有重要意义。
Objective To investigate the value of monitoring electrocardiogram (BNP) combined with BNP in the prognosis of elderly patients with acute left heart failure (ALHF). Methods Plasma BNP levels were measured in 128 patients with acute exacerbation of ALHF within 6 hours and at 24 and 72 hours, and routine electrocardiogram was performed. The patients were divided into the ideal prognosis group (60 cases), the poor prognosis group (45 cases) and the death group (23 cases) according to the status of patients discharged from the hospital. Results The prognosis of ideal group at 24,72 h after acute exacerbation of plasma BNP, QRS wave duration and QTc interval decreased compared with poor prognosis group and death group were significantly (P <0.05), while the death group QRS wave duration, QTc interval Showing an extension trend. Multivariate Logistic regression analysis showed that BNP and QRS wave QTc interval is an independent risk factor affecting the prognosis of patients. Conclusions Dynamic changes of plasma BNP and ECG during several consecutive time points are of great significance in evaluating the prognosis and death of elderly patients with ALHF.