急性肺栓塞患者心电图表现与临床预后的关系
Relationship between ECG and clinical outcome in patients with acute pulmonary embolism during hospitalization

目的:分析急性肺栓塞患者的心电图表现,探讨急性肺栓塞患者心电图表现对临床预后的评估作用。方法:回顾性分析525例急性肺栓塞患者的心电图特征,以病情危重和临床死亡为观察事件,采用logistic回归分析急性肺栓塞患者心电图表现与住院期间临床预后的关系。结果:525例肺栓塞患者中60例住院期间死亡,108例病情危重。心率>100 min-1、完全性右束支传导阻滞、房颤是APE患者住院期间死亡的预后影响因素[OR(95%CI)=4.366(2.361～8.073)、4.546(1.675～12.336)、2.797(1.112～7.036),P<0.05]; 同时V1导联QR波、心率>100 min-1、房颤、TV3倒置是APE患者住院期间病情危重的预后影响因素[OR(95%CI)=3.150(1.292～7.678)、2.865(1.790～4.586)、2.733(1.190～6.276)和2.201(1.326～3.653),P<0.05]。结论:心率>100 min-1、房颤、V1导联QR波、完全性右束支传导阻滞及TV3倒置是急性肺栓塞患者住院期间预后不良的影响因素。
Aim: To assess the role of electrocardiographic(ECG)in estimating clinical outcome of patients hospitalized with acute pulmonary embolism(APE)by analyzing the different ECG patterns.Methods: A retrospective analysis of 525 patients who had confirmed APE was performed, and multiple logistic regression was used to analyze the relationship between ECG and clinical outcome in patients with APE during the hospital.Results: Among 525 patients with APE,108 developed complications and 60 died during hospitalization.Multiple logistic regression revealed that sinus tachycardia, complete right bundle branch block, and atrial fibrillation were the significant independent predictors of death[OR(95%CI)=4.366(2.361-8.073),4.546(1.675-12.336), and 2.797(1.112-7.036),P<0.05]; QR in V1,sinus tachycardia, atrial fibrillation, and T wave inversion in V3 were the significant independent predictors of complicated APE[OR(95%CI)=3.150(1.292-7.678),2.865(1.790-4.586), 2.733(1.190-6.276), and 2.201(1.326-3.653),P<0.05].Conclusion: Sinus tachycardia, atrial fibrillation, QR in V1, complete right bundle branch block and T wave inversion in V3 could be the independent predictors of adverse clinical outcome in patients with APE during hospitalization