冠心病合并慢性心力衰竭发生风险的多因素相关分析

李佳欣; 范平

doi:null

您当前的位置：

首页 >

文章列表页 >

冠心病合并慢性心力衰竭发生风险的多因素相关分析

论著 | 更新时间：2026-04-28

- 冠心病合并慢性心力衰竭发生风险的多因素相关分析
- Multivariate Correlation Analysis of Risk Factors for Coronary Heart Disease Complicated with Chronic Heart Failure
- 临床心电学杂志 2026年35卷第2期页码：129-136
- 作者机构：
  
  1.830002 新疆乌鲁木齐，新疆医科大学第一附属医院心内科（李佳欣）
  2.830002 新疆乌鲁木齐，新疆医科大学第一附属医院心功能科（范平）
- 作者简介：
  
  李佳欣，硕士研究生，主要从事心血管疾病研究。
  范平，E-mail：xjarrhyvip@163.com
- 基金信息：
  
  “天山英才”医药卫生领军人才项目(TSYC202401A069);自治区卫生健康科技计划项目(2025001MXJCSYJSTGXM650030286);老年人临床检验智慧云服务平台和临床检验系统示范推广项目(LY2025JY016)
- DOI：
  中图分类号： R541.7　R540.4+1
- 收稿：2025-12-25，
  
  修回：2026-01-28，
  
  录用：2026-02-02，
  
  纸质出版：2026-04-28
- 稿件说明：
移动端阅览
李佳欣, 范平. 冠心病合并慢性心力衰竭发生风险的多因素相关分析[J]. 临床心电学杂志, 2026, 35(2): 129-136.

Li Jiaxin,Fan Ping.Multivariate Correlation Analysis of Risk Factors for Coronary Heart Disease Complicated with Chronic Heart Failure[J].J Clin Electrocardiol,2026,35(02):129-136.
李佳欣, 范平. 冠心病合并慢性心力衰竭发生风险的多因素相关分析[J]. 临床心电学杂志, 2026, 35(2): 129-136. DOI：

Li Jiaxin,Fan Ping.Multivariate Correlation Analysis of Risk Factors for Coronary Heart Disease Complicated with Chronic Heart Failure[J].J Clin Electrocardiol,2026,35(02):129-136. DOI：

摘要

目的

探讨临床资料和24小时动态心电图与冠心病（CHD）患者合并慢性心力衰竭（CHF）的相关性。

方法

本研究为一项回顾性横断面研究，选取2023年1月至2024年12月期间于新疆医科大学第一附属医院或4家合作中心医院住院接受诊治的424例CHD患者作为研究对象，收集患者住院期间临床资料，包括年龄、性别、白细胞、红细胞、血小板、白蛋白、天门冬氨酸氨基转移酶（AST）、估算肾小管滤过率（eGFR）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白、左心室收缩末期内径（LVESD）、肺动脉收缩压（PASP）和左心室射血分数（LVEF）等指标以及24小时动态心电图中的最慢心率、最快心率、全程每5分钟NN间期均值标准差（SDNN）、三角指数、QT平均QTc间期和心率减速力（DC）等监测指标。根据是否合并CHF将CHD患者分为心衰组（

=227）和非心衰组（

=197），对比两组患者的临床特征，采用多因素logistic回归分析CHD患者合并CHF的相关因素。

结果

多因素logistic回归分析结果显示，在动态心电图监测指标中，SDANN（

=0.943，95%

：0.906~0.981，

0.05）与CHD合并CHF呈负相关；QT平均QTc间期（

=1.008，95%

：1.001~1.014，

0.05）与CHD合并CHF呈正相关。在临床资料中，白蛋白（

=0.925，95%

：0.859~0.996，

0.05）、LVEF（

=0.930，95%

：0.902~0.960，

0.001）与CHD合并CHF呈负相关；LDL-C（

=1.734，95%

：1.146~2.625，

0.05）、AST（

=1.030，95%

：1.008~1.053，

0.05）、PASP（

=1.172，95%

：1.068~1.286，

=0.001）与CHD合并CHF呈正相关。

结论

SDANN、QT平均QTC间期、白蛋白、LDL-C、AST、PASP和LVEF是CHD合并CHF的相关因素。这些相关因素可辅助临床医生早期识别CHD合并CHF的高风险患者，对及时治疗以延缓病情进展具有重要意义。

Abstract

Objective To explore the correlation of clinical data and 24-hour Holter electrocardiogram in patients with coronary heart disease(CHD) complicated with chronic heart failure(CHF). Methods This retrospective cross-sectional study included 424 patients with CHD who were hospitalized

for diagnosis and treatment at the First Affiliated Hospital of Xinjiang Medical University or four collaborating center hospitals from January 2023 to December 2024. The clinical data during the patients' hospitalization

including age

gender

white blood cells

red blood cells

platelets

estimated glomerular filtration rate (eGFR)

triglycerides (TG)

total cholesterol (TC)

low-density lipoprotein (LDL-C)

glycated hemoglobin

Left ventricular end-diastolic diameter (LVESD)

pulmonary artery systolic pressure (PASP) and left ventricular ejection fraction (LVEF)were all collected.The monitoring indicators of 24-hour Holter electrocardiogram such as the slowest heart rate

the fastest heart rate

the standard deviation of NN intervals (SDNN)

the triangular index

the average QTC interval of QT

and the heart rate deceleration rate (DC) were also collected. The research subjects were divided into the heart failure group (

=227) and the non-heart failure group (

=197) based on whether the CHD patients complicated with CHF. The clinical characteristics of the two groups were compared and the multivariate Logistic regression analysis was used to explore the relevant factors in patients with CHD complicated with CHF. Results Among the indicators monitored by Holter electrocardiogram

the results of multivariate Logistic regression analysis showed that the SDANN index (

=0.943

95%

: 0.906~0.981

0.05) was negatively correlated with CHD combined with CHF; the average QTC interval of QT (

=1.008

95%

: 1.001~1.014

0.05) was positively correlated with CHD combined with CHF. In the clinical data

the results of multivariate Logistic regression analysis showed that the albumin (

=0.925

95%

: 0.859~0.996

0.05)

LVEF (

=0.930

95%

:0.902~0.960

0.001) were n

egatively correlated with CHD combined with CHF; LDL-C (

=1.734

95%

: 1.146~2.625

0.05)

AST(

=1.030

95%

: 1.008~1.053

0.05)

PASP (

=1.172

95%

: 1.068~1.286

0.001) were positively correlated with CHD combined with CHF. Conclusions The SDANN index

average QTc interval of QT

albumin

LDL-C

AST

PASP and LVEF are the relevant factors for CHD combined with CHF. These relevant factors can assist clinicians in identifying high-risk patients with CHD combined with CHF at an early stage

which is of great significance for timely treatment to delay the progression of the disease.

关键词

Keywords

references

钟竹青 , 王瑜 , 姚自强 , 等 . 量化自我在慢性心力衰竭患者容量管理中的应用进展 [J ] . 中国护理管理 , 2024 , 24 ( 7 ): 973 - 977 .

Liu R , Ji H , Wang J , et al . Integrated cardiopulmonary rehabilitation nursing for chronic heart failure: An integrative literature review [J ] . Geriatr Nurs , 2025 , 65 : 103472 .

王华 , 李莹莹 , 柴坷 , 等 . 中国住院心力衰竭患者流行病学及治疗现状 [J ] . 中华心血管病杂志 , 2019 , 47 ( 11 ): 865 - 874 .

葛均波 , 霍勇 , 杨杰孚 , 等 . 慢性心力衰竭“新四联”药物治疗临床决策路径专家共识 [J ] . 中国循环杂志 , 2022 , 37 ( 8 ): 769 - 781 .

Roth G A , Mensah G A , Johnson C O , et al . Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study [J ] . J Am Coll Cardiol , 2020 , 76 ( 25 ): 2982 - 3021 .

Singh P K , Kumar T , Pandit B N , et al . Correlation between cardiac autonomic dysfunction and severity of coronary artery lesions in patients with chronic coronary syndrome [J ] . Cureus , 2024 , 16 ( 12 ): e75756 .

Bogdan C , Apostol A , Ivan V M , et al . Heart rate variability and global longitudinal strain for prognostic evaluation and recovery assessment in conservatively managed post-myocardial infarction patients [J ] . J Clin Med , 2024 , 13 ( 18 ): 5435 .

Zhao Y , Yu H T , Gong A W , et al . Heart rate variability and cardiovascular diseases: A Mendelian randomization study [J ] . Eur J Clin Invest , 2024 , 54 ( 1 ): e14085 .

中华医学会心血管病学分会介入心脏病学组 , 中华医学会心血管病学分会动脉粥样硬化与冠心病学组 , 中国医师协会心血管内科医师分会血栓防治专业委员会 , 等 . 稳定性冠心病诊断与治疗指南 [J ] . 中华心血管病杂志 , 2018 , 46 ( 9 ): 680 - 694 .

中华医学会心血管病学分会 , 中国医师协会心血管内科医师分会 , 中国医师协会心力衰竭专业委员会 , 等 . 中国心力衰竭诊断和治疗指南2024 [J ] . 中华心血管病杂志 , 2024 , 52 ( 3 ): 235 - 275 .

Quinlan G J , Martin G S , Evans T W . Albumin: Biochemical properties and therapeutic potential [J ] . Hepatology , 2005 , 41 ( 6 ): 1211 - 1219 .

Utariani A , Rahardjo E , Perdanakusuma D S . Effects of albumin infusion on serum levels of albumin, Proinflammatory cytokines (TNF-α, IL-1, and IL-6), CRP, and MMP-8; tissue expression of EGRF, ERK1, ERK2, TGF-β, collagen, and MMP-8; and wound healing in sprague dawley rats [J ] . Int J Inflam , 2020 , 2020 : 3254017 .

Ronit A , Kirkegaard-Klitbo D M , Dohlmann T L , et al . Plasma albumin and incident cardiovascular disease: results from the CGPS and an updated meta-analysis [J ] . Arterioscler Thromb Vasc Biol , 2020 , 40 ( 2 ): 473 - 482 .

Chien S C , Chen C Y , Leu H B , et al . Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease [J ] . Int J Cardiol , 2017 , 241 : 1 - 5 .

Gomes R , Aguiar C . Revisiting the "cholesterol paradox" in heart failure. Is LDL-cholesterol a target of treatment or a marker of risk? [J ] . Rev Portuguesa De Cardiol , 2025 , 44 ( 4 ): 201 - 203 .

门莉 , 刘瑞 , 杨龙 , 等 . 基于动态心电图定量参数建立并验证冠心病患者经皮冠状动脉介入治疗术后主要不良心血管事件预测模型 [J ] . 中国心血管病研究 , 2025 , 23 ( 6 ): 510 - 518 .

Theresa A McDonagh , Marco Metra , Marianna Adamo , et al . 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure [J ] . Eur Heart J , 2021 , 42 ( 36 ): 3599 - 3726 .

姜琳 , 宋莹 , 许晶晶 , 等 . 转氨酶升高对急性冠脉综合症患者预后的影响 [J ] . 中国分子心脏病学杂志 , 2020 , 20 ( 6 ): 3606 - 3609 .

田永锋 , 刘锐锋 , 张德强 , 等 . 入院天门冬氨酸氨基转移酶水平与急性心肌梗死患者主要不良心血管事件的相关性分析 [J ] . 医师在线 , 2025 , 15 ( 4 ): 17 - 21 .

吕群星 , 张松美 , 林鹏生 , 等 . 心脏彩色多普勒超声对左室肥厚伴左心衰竭的诊断价值 [J ] . 心血管康复医学杂志 , 2025 , 34 ( 2 ): 184 - 189 .

陆赵阳 , 徐卫华 , 徐敏 . 心脏彩色多普勒超声对慢性心力衰竭患者的诊断价值分析 [J ] . 影像研究与医学应用 , 2023 , 7 ( 11 ): 109 - 111 .

Riccardi M , Sammartino A M , Adamo M , et al . Cardiac contractility modulation: an effective treatment strategy for heart failure beyond reduced left ventricular ejection fraction? [J ] . Heart Fail Rev , 2023 , 28 ( 5 ): 1141 - 1149 .

Vanderpool R R , Naeije R . Progress in pulmonary hypertension with left heart failure. beyond new definitions and acronyms [J ] . Am J Respir Crit Care Med , 2015 , 192 ( 10 ): 1152 - 1154 .

Gerges M , Gerges C , Pistritto A M , et al . Pulmonary hypertension in heart failure. epidemiology,right ventricular function,and survival [J ] . Am J Respir Crit Care Med , 2015 , 192 ( 10 ): 1234 - 1246 .

Duca S T , Badescu M C , Costache A D , et al . Harmony in chaos: deciphering the influence of ischemic cardiomyopathy and non-cardiac comorbidities on holter ECG parameters in chronic heart failure patients: a pilot study [J ] . Medicina (Kaunas) , 2024 , 60 ( 2 ): 342 .

Liu H B , Wang X T , Wang X W . The correlation between heart rate variability index and vulnerability prognosis in patients with acute decompensated heart failure [J ] . PeerJ , 2023 , 11 : e16377 .

Shaffer F , Ginsberg J P . An overview of heart rate variability metrics and norms [J ] . Front Public Health , 2017 , 5 : 258 .

Tiwari R , Kumar R , Malik S , et al . Analysis of heart rate variability and implication of different factors on heart rate variability [J ] . Curr Cardiol Rev , 2021 , 17 ( 5 ): e160721189770 .

Al-Zaiti S S , Pietrasik G , Carey M G , et al . The role of heart rate variability, heart rate turbulence, and deceleration capacity in predicting cause-specific mortality in chronic heart failure [J ] . J Electrocardiol , 2019 , 52 : 70 - 74 .

王玉珍 , 张成 , 黄美兰 . 动态心电图、超声心动图在诊断冠心病心力衰竭中的应用价值 [J ] . 卫生职业教育 , 2019 , 37 ( 24 ): 145 - 147 .

Chen B X , Men L , Wang H L , et al . The application value of 24 h Holter monitoring indices in predicting MACEs outside the hospital within three years after PCI in patients with STEMI [J ] . Front Cardiovasc Med , 2024 , 11 : 1401343 .

Tomaselli Muensterman E , Tisdale J E . Predictive analytics for identification of patients at risk for QT interval prolongation: a systematic review [J ] . Pharmacotherapy , 2018 , 38 ( 8 ): 813 - 821 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

老年冠心病患者不停跳冠脉搭桥术后发生房颤的影响因素分析

动态心电图ST段改变、平面QRS-T夹角对冠心病心肌缺血的预测价值分析

经导管主动脉瓣置换术联合经皮冠脉介入术、外科主动脉瓣置换术联合冠脉旁路移植术治疗主动脉瓣狭窄合并冠心病的效果

应用艾司洛尔治疗冠心病合并快速心律失常

应用心电图及动态心电图评估心肌缺血的比较