钟桂年.颅脑创伤患者早期并发心脏收缩功能不全存在较多影响因素[J].内科急危重症杂志,2024,30(3):235-238
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| DOI：10.11768/nkjwzzzz20240308 |
| 中文关键词: 颅脑创伤 心脏收缩功能不全 相关因素 受试者工作特征曲线 超声心动图 |
| 英文关键词: |
| 基金项目:茂名市科技计划项目（2021009） |
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| 中文摘要: |
| 摘要 目的：研究颅脑创伤患者早期并发心脏收缩功能不全相关因素。方法：收集123例单纯性颅脑创伤（iTBI）患者的临床资料，均行超声心动图检测，根据检测结果将患者分为心脏收缩功能正常组（100例）及心脏收缩功能不全组(23例)。比较2组患者的临床资料，采用Logistic回归分析影响患者并发心脏收缩功能不全的相关因素，绘制受试者工作特征（ROC）曲线评估各指标对iTBI患者并发心功能不全的预测价值。结果：与心脏收缩功能正常组比较，心脏收缩功能不全组入院时格拉斯哥昏迷（GCS）评分更低；而入院时心率、收缩压及血清hs-cTnT水平更高（P均＜0.05）。多因素Logistic回归分析显示，入院时心率、GCS评分、血清hs-cTnT是iTBI患者并发心脏收缩功能不全的影响因素（P均＜0.05）。经ROC曲线分析入院时血清hs-cTnT水平预测iTBI患者并发心脏收缩功能不全的曲线下面积、灵敏度、特异性及约登指数高于入院时心率和GCS评分预测（P均＜0.05）。结论：iTBI患者早期并发心脏收缩功能不全相关因素包括入院时心率、GCS评分、血清hs-cTnT水平，其中入院时血清hs-cTnT水平预测iTBI患者早期并发心脏收缩功能不全的效能较高。 |
| 英文摘要: |
| Abstract Objective: To study the factors associated with early cardiac systolic dysfunction in patients with isolated traumatic brain injury (iTBI). Methods: The clinical data of 123 patients with simple craniocerebral trauma (iTBI) were collected and tested by echocardiography. According to the test results, the patients were divided into normal systolic function group (n=100) and incomplete systolic function group (n=23). The clinical data of patients in the 2 groups were compared, Logistic regression analysis was used to analyze the related factors influencing concurrent cardiac systolic dysfunction, and the receiver operating characteristics (ROC) curve was drawn to evaluate the predictive value of each index for concurrent cardiac dysfunction in patients with iTBI. Results: Glasgow Coma (GCS) scores were lower in the normal systolic function group; heart rate, systolic blood pressure and serum hs-cTnT were higher on admission than in the incomplete systolic function group (all P< 0.05). Multivariate Logistic regression analysis showed that heart rate, GCS score, and serum hs-cTnT at admission were the influencing factors of concurrent cardiac systolic dysfunction in patients with iTBI (all P <0.05). The ROC curve analysis revealed that serum hs-cTnT level predicted the area, sensitivity, specificity and the Youden index in iTBI was higher than that of the heart rate and GCS score prediction at admission (all P < 0.05). Conclusion: Factors associated with early concurrent cardiac systolic insufficiency in iTBI include admission heart rate, GCS score, and serum hs-cTnT level, of which serum hs-cTnT level at admission had a higher efficacy to predict early complicated cardiac systolic insufficiency in iTBI patients. |
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