冠状动脉旁路移植术后心输出量减低的预测因子分析

Screening of predictive factors for hypokinemia post coronary artery bypass grafting

摘要:

目的 探讨冠状动脉旁路移植术（CABG）后心输出量减低的预测因子。方法 选取在该院行CABG 的159 例患者，自术前跟踪随访至术后完成心输出量评估。采用单因素和多因素回归分析，记录患者术前、术中及术后各影响因素与术后心输出量减低的相关性；采用ROC 曲线分析预测因素的准确性、特异性及敏感性。结果 年龄[O^R=3.317（95%CI ：1.432，7.685）]、术前心室射血分数[O^R=1.043（95%CI ：1.003，1.085）] 和未使用桡动脉[O^R=11.057（95%CI ：1.063，14.978）] 是预测CABG 术后低心输出量综合征（LCOS）的独立预测因子。预测的准确率为0.815（95%CI ：0.541，1.089），特异性为0.872（95%CI ：0.602，1.127），敏感性为0.629（95%CI ：0.427，0.786）。结论 年龄、术前心室射血分数及桡动脉使用与否在预测CABG 术后LCOS 的预测中具有较好的价值。

Abstract:

Objective To investigate the predictive factors for hypokinemia post coronary artery bypass grafting. Method Totally 159 patients admitted into our hospital have been enrolled and followed up till the complement of cardiac output evaluation. Independent factors were recorded and analyzed with simple logistic regression analysis and multiple logistic regression analysis pre-, intro- and post- surgery. The accuracy, specificity and sensitivity were calculated by ROC curve. Result The Accuracy, specificity and sensitivity of the predictors was 0.815 (95% CI: 0.602, 1.127), 0.872 (95% CI: 0.427, 0.786) and 0.629 (95% CI: 0.541, 1.089), respectively. The O^R of age, preoperative ventricular ejection fraction, and usage of radial artery was 3.317 (95% CI: 1.432, 7.685), 1.043(95% CI: 1.003, 1.085), and 11.057 (95% CI: 1.063, 14.978), respectively. Conclusion Age, preoperative ventricular ejection fraction and avoidance of radial artery are independent predictive factors of hypokinemia post coronary artery bypass grafting.