【摘要】 目的：探讨超声心动图测量心输出功率(CPO)对老年急性心力衰竭患者心衰易损期预后的预测价值。方法：回顾性选取2021年1月至2024年1月于山西医科大学附属第三医院收治的120例老年急性心力衰竭患者，按患者出院后3个月内是否出现易损期主要不良心血管事件(MACE)将其分为MACE组(18例)和非MACE组(102例)，比较两组患者基线资料，采用logistic回归分析患者发生易损期MACE的影响因素，采用受试者工作特征(ROC)曲线分析CPO对老年急性心力衰竭患者心衰易损期MACE的预测价值。结果：MACE组患者基线资料中总胆固醇、25-羟基维生素D[25(OH)D]、储备CPO、静息CPO及峰值CPO均低于非MACE组，其差异有统计学意义(t=5.987、2.236、2.921、2.390、4.569,P<0.05),MACE组脑钠肽(BNP)、N末端脑钠肽前体(NT-proBNP)均高于非MACE组，其差异有统计学意义(t=22.074、23.368,P<0.05)。logistic回归分析结果显示总胆固醇、25(OH)D、储备CPO、静息CPO、峰值CPO均为患者心衰易损期发生MACE的影响因素(OR=0.064、0.942、0.015、0.035、0.041,P<0.05);ROC曲线分析显示，心脏功能指标中峰值CPO预测患者MACE的AUC、灵敏度和特异度分别为0.752、92.2%和55.6%。结论：超声心动图心脏功能指标峰值CPO较低是老年急性心力衰竭患者心衰易损期MACE的独立危险因素，测量CPO可提前识别潜在的不良预后人群。更多还原

【Abstract】 Objective: To investigate the predictive value of measured cardiac power output(CPO) of echocardiography for the prognosis of elderly patients with acute heart failure(AHF) in the vulnerable period of heart failure. Methods: A total of 120 elderly patients with AHF who admitted to the Third Hospital Affiliated to Shanxi Medical University from January 2021 to January 2024were selected, and they were divided into the major adverse cardiovascular events(MACE) group(18 cases) and the non-MACE group(102 cases) according to whether occurred MACE in the vulnerable period within 3 months after discharge. The baseline data of the two groups of patients were compared. Logistic regression was used to analyze the influencing factors of occurring MACE in the vulnerable period of patients, and the receiver operating characteristic(ROC) curve was used to analyze the predictive value of CPO for MACE in the vulnerable period of heart failure in elderly patients with AHF. Results: In the baseline data of patients,the total cholesterol, 25-hydroxyvitamin D [25(OH)D], reserve CPO, resting CPO, and peak CPO in the MACE group were all lower than those in the non-MACE group, and the differences were statistically significant(t=5.987, 2.236, 2.921, 2.390, 4.569,P<0.05). The levels of brain natriuretic peptide(BNP) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in the MACE group were higher than those in the non-MACE group, and the differences were statistically significant(t=22.074, 23.368, P<0.05).The results of Logistic regression analysis showed that the total cholesterol, 25(OH)D, reserve CPO, resting CPO, and peak CPO were all influencing factors for the occurrence of MACE during the vulnerable period of heart failure in patients(OR=0.064, 0.942,0.015, 0.035, 0.041, P<0.05). ROC curve analysis showed that the efficacy of resting CPO and reserve CPO of the cardiac function indicators in predicting MACE of patients were slightly lower than that of peak CPO. The AUC, sensitivity and specificity of peak CPO in predicting MACE of patients were 0.752, 92.2% and 55.6%, respectively. Conclusion: The lower peak CPO value of cardiac function indicator of echocardiography is independent risk factor for MACE during the vulnerable period of heart failure in elderly patients with AHF. Measuring CPO can identify potential poor prognosis populations in advance.更多还原