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目的:探讨完全性右束支传导阻滞(CRBBB)与急性心力衰竭(AHF)患者长期病死率之间的相关性。方法:入选2012-03-2015-02因AHF入住我院的患者346例,收集与分析入选者的临床资料及入院时的相关检验及检查结果,前瞻性随访所有患者18个月,其终点事件为全因死亡。根据终点事件将其分为死亡组和生存组。结果:(1)39例(11.3%)失访,73例(23.8%)死亡;(2)完成随访的307例AHF患者中有35例(11.4%)合并CRBBB,其中生存组中有17例,而死亡组中18例(P<0.01);(3)Kaplan-Meier分析后发现合并CRBBB的AHF患者死亡风险明显高于无CRBBB的AHF患者(P<0.01);(4)CRBBB用于预测AHF患者预后的特异度可达92.7%(95%CI88.6~95.7),敏感度为24.7%(95%CI 15.3~36.1);(5)COX逐步回归分析(向前)显示,合并CRBBB的AHF患者比无CRBBB的AHF患者死亡风险超过2倍(HR=3.912,95%CI 2.208~6.933)。结论:CRBBB对评估AHF患者长期预后有重要价值。
Objective: To investigate the association 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 from 2012-03-2015-02 were enrolled in this study. The clinical data of the selected patients were collected and analyzed. The related tests and results at admission were prospectively followed up. All patients were prospectively followed up for 18 months. For all causes of death. According to the end point, they were divided into death group and survival group. RESULTS: Thirty-nine patients (11.3%) were lost to follow-up and 73 patients (23.8%) were deceased. (2) Out of the 307 AHF patients who completed follow-up, 35 (11.4%) had CRBBB, (P <0.01). (3) The Kaplan-Meier analysis showed that the death risk of AHF patients with CRBBB was significantly higher than that of AHF patients without CRBBB (P <0.01). (4) CRBBB was used to predict The specificity of AHF was 92.7% (95% CI 88.6-95.7) and sensitivity was 24.7% (95% CI 15.3-36.1). (5) The stepwise regression analysis of COX (forward) showed that the combined outcome of CRBBB Patients with AHF had a more than 2-fold greater risk of death than those without CRBBB (HR = 3.912, 95% CI 2.208 to 6.933). Conclusion: CRBBB is of great value in assessing the long-term prognosis of patients with AHF.