| 徐佳,徐杨燕,高波,姜建平.时间加权乳酸对急性心力衰竭患者短期不良结局的预测作用[J].浙江中西医结合杂志,2024,34(4): |
| 时间加权乳酸对急性心力衰竭患者短期不良结局的预测作用 |
| Predictive effect of time-weighted lactic acid on adverse outcomes in patients with acute heart failure |
| 投稿时间：2023-08-02 修订日期：2024-02-19 |
| DOI： |
| 中文关键词: 时间加权乳酸 急性心力衰竭 心血管事件 |
| 英文关键词:time-weighted lactic acid acute heart failure adverse cardiovascular event |
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| 中文摘要: |
| 目的：探索时间加权乳酸(LACTW)对急性心力衰竭患者短期不良结局的预测作用。方法：前瞻性纳入在本院住院的AHF患者96例。采集患者的临床和实验室检查指标。采集入院后即刻和随后的2 h、6 h、12 h和24 h动脉血并测量乳酸浓度,采用公式计算入院24 小时LACTW。多因素Logistic回归模型分析发生院内重要心血管事件的独立危险因素。通过测量受试者工作特征曲线下(ROC)面积评估LACTW预测结局的能力。根据约登指数最大值选择LACTW的最佳临界值。结果：多因素Logistic回归分析结果显示,LACTW是住院期间发生心血管事件的独立危险因素(OR: 1.51,95%CI: 1.24~1.84,P < 0.001)。LACTW预测住院期间心血管事件的ROC曲线下面积为0.928(95%CI: 0.880,0.976,P < 0.0001),得到最佳临界值为2.2(敏感性为88%,特异性为83%)。结论：AHF患者在入院后24h的LACTW水平对院内短期不良心血管结局有独立预测价值,可作为识别具有潜在不良结局风险患者的有用指标。 |
| 英文摘要: |
| Objective: To explore the predictive effect of time-weighted average lactate, LACTW on adverse outcomes in patients with acute heart failure. Methods: Sixty-six patients with AHF admitted to the Department of Cardiology of our hospital were prospectively included. Clinical and laboratory indicators were collected from patients. Arterial blood was collected immediately after admission (C0) and subsequently at 2, 6, 12, and 24 h, and lactate concentration was measured. 24-hour LACTW was calculated using a formula. Multivariate Logistic regression model was used to analyze independent risk factors for major in-hospital cardiovascular events. The ability of the LACTW to predict outcomes was assessed by measuring the area under the receiver operating characteristic curve (ROC). Selected the optimal threshold for the LACTW based on the maximum of the Yorden index. Results: Multivariate Logistic regression analysis showed that LACTW was an independent risk factor for cardiovascular events during hospitalization (OR:1.51, 95%CI: 1.24-1.84, P＜0.001).The area under the ROC curve of LACTW for predicting cardiovascular events during hospitalization was 0.928 (95%CI: 0.880, 0.976, P＜0.0001) with an optimal cut-off value of 2.2 (sensitivity 88%, specificity 83%). Conclusions: The LACTW level in patients with AHF at 24 hours after admission has independent predictive value for adverse cardiovascular outcomes in the hospital and can be used as a useful indicator to identify patients at risk for potentially adverse outcomes. |
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