Objective To investigate the relationship between prolonged QRS duration in inferior and lateral leads and short-term outcomes of patients with acute pulmonary embolism(APE).Methods A total of 101 patients with APE diagnosed by pulmonary CT angiography in Ruian People's Hospital from January 2021 to June 2022 were included.According to QRS duration in inferior and lateral leads,the patients were divided into QRS duration≥100ms group(n=42)and QRS duration＜100 ms group(n=59).The past medical history,the results of laboratory examination,electrocardiogram and echocardiography at admission were collected.Cox proportional hazards model was used to analyze influencing factors of death within 30 days after APE.Results The percentage of patients with chronic lung disease was significantly higher in QRS duration≥100 ms group than in QRS duration＜100 ms group(P＜0.05).The proportion of cardiac arrest,syncope,medium to high risk,and high-risk patients,cTnI,and mortality within 30 days in the QRS duration≥100 ms group were higher than those in the QRS duration＜100 ms group,and SpO2 was lower than that in the QRS duration＜100 ms group(all P＜0.05).Cox univariate analysis showed that heart failure,chronic lung disease,cardiac arrest,high-risk,QRS duration≥100 ms were associated with death within 30 days after APE(all P＜0.05).Cox multivariate analysis showed that heart failure and QRS duration≥100 ms were independent predictive factors for the death of APE within 30 days(all P＜0.05).Conclusion APE patients with prolonged QRS duration in inferior and lateral leads have higher mortality rate with 30 days.
描述和综合国内外泛血管疾病(PVD)生物标志物的相关研究,根据范围综述的研究方法,在中国知网、万方数据库、维普网、PubMed、Embase、Web of Science、Cochrane Library等数据库进行系统检索,检索时间为建库至 2023年 1 月17日.2名研究人员依据文献纳入标准和排除标准独立进行文献筛选和数据资料提取.共纳入16篇文献,其中队列研究6篇、病例对照研究5篇、横断面研究4篇、Meta分析1篇.基于动脉粥样硬化形成机制假说对纳入的PVD生物标志物进行分类梳理,并从PVD危险因素以及PVD生物标志物在疾病预测和筛查中的效能进行分析,旨在为未来推广PVD早诊早筛、提升综合防治水平提供参考依据.
急性心肌梗死(下称心梗)是一种严重威胁人类生命健康的心血管急重症,心梗后梗死面积大小与心力衰竭和心律失常等的发生有关.血液生物学标志物(尤其生物学心肌标志物)一直以来在急性心梗的诊断、危险分层、预后评估中备受关注.本文对血液生物学标志物预测心梗面积的研究进展进行综述.
Objective To investigate the detection value of plasma microRNA-195(miR-195),soluble growth stimulation expressed gene 2(sST2),myoglobin(Myo)and cathepsin S(CatS)in patients with acute myocardial infarction(AMI).Methods One hundred and five patients with AMI(observation group)and 94 healthy individuals(control group)were enrolled in this study between April 2019 and October 2020 in Pingyang County People's Hospital.Plasma miR-195,sST2,Myo and CatS were measured.All patients were followed up for 6 months and then were divided into poor outcome group(24 cases)and good outcome group(81 cases)based on the disease prognosis.Plasma miR-195,sST2,Myo and CatS were compared between the two groups.The predictive value of those parameters for the prognosis of AMI patients was analyzed.Results Plasma miR-195,sST2,Myo and CatS were significantly higher in the observation group than in the control group(all P＜0.05).Pearson correlation analysis showed a positive correlation between plasma miR-195,sST2,Myo,and CatS(all P＜0.05).Plasma miR-195,sST2,Myo,and CatS were significantly higher in poor outcome group than in good outcome group(all P＜0.05).Univariate analysis and multivariate Cox regression analysis revealed that abnormally elevated plasma miR-195,sST2,Myo and CatS were the risk factors for poor prognosis of AMI patients(all P＜0.05).The AUC value and sensitivity of a combination of miR-195,sST2,Myo and CatS for predicting prognosis of AMI patients were significantly higher than those of each index(all P＜0.05).Conclusion High expression of plasma miR-195,sST2,Myo and CatS is related to poor prognosis of AMI patients.
目的 探究不同包扎方法对经桡动脉行冠状动脉介入术(TRI)后创口安全性及舒适度的影响.方法 选择2018年12月至2020年12月温州医科大学附属新昌医院心血管内科接受TRI患者220例.采用随机数字表法分为观察组和对照组,各110例.观察组患者采用旋压式止血器压迫板及压迫垫软胶的下方置入纱布止血.对照组患者采用旋压式止血器压迫板下方置入纱布止血.比较两组患者一次止血成功率、止血时间、术后视觉模拟评分法(VAS)评分及并发症发生率,比较两组患者的舒适度评分及舒适度满意度.结果 观察组患者术后VAS评分低于对照组,肿胀、疼痛及皮损发生率低于对照组,差异均有统计学意义(均P＜0.01).观察组舒适度评分低于对照组,舒适度满意度高于对照组,差异均有统计学意义(均P＜0.01).结论 旋压式止血器压迫板可显著提升TRI术后患者的止血效果,舒适度高,且能够降低术后并发症发生率,值得临床推广.
心率变异性(HRV)可用来评估病情严重程度及预后情况.常规测量HRV的设备存在佩戴贴片多、电极片易脱落、舒适度不高等问题.智能贴片、基于光学体积描记术(PPG)和纺织品的可穿戴设备凭借穿戴简单、舒适度高和报告自动化等优点,广泛应用于HRV测量中.可穿戴HRV设备有望成为临床健康监测的新策略.本文对可穿戴HRV设备的类型、应用场景、存在的问题及未来展望进行综述.
Objective Exploring the value of quantitative analysis of coronary CT angiography(CCTA)in identifying plaque types and major adverse cardiovascular events(MACE).Methods A total of 100 patients with unstable angina pectoris(UAP)treated at Affiliated Hangzhou Hospital First People's Hospital,Westlake University School of Medicine from June 2017 to April 2019 were selected and underwent CCTA.The measurements include lipid volume,lipid percentage,fibrous volume,fibrous percentage,calcification volume and calcification ratio.Among them,57 patients had vulnerable plaque(vulnerable group)and 43 patients had no vulnerable plaque(stable group).The measurements were compared between the two groups.All patients were followed up for 3 months and then divided into MACE group with MACE occurred and non-MACE group without MACE.ROC curve was used to determine the value of the measurements in predicting MACE.Results The lipid percentage was significantly higher,while the fibrous volume,calcification volume,and calcification ratio were significantly lower in vulnerable group than in stable group(all P＜0.05).The diagnostic value of calcification volume for vulnerable plaques was the highest,followed by calcification ratio,fibrous volume,and lipid percentage.In MACE group,the lipid percentage was significantly greater and the fibrous volume,calcification volume,and calcification ratio were significantly lower than that in non-MACE group(all P＜0.05).The predictive value of calcification volume for MACE was the highest,followed by calcification ratio,fibrous volume,and lipid percentage.Conclusion Quantitative analysis of CCTA has a higher clinical value in identifying plaque type and predicting MACE in UAP patients.
肥厚型梗阻性心肌病(HOCM)是最常见的遗传性心血管疾病,对于存在药物难治性心力衰竭症状(纽约心脏病协会心功能分级Ⅲ～Ⅳ级)且静息状态或生理(运动)激发时左心室流出道压力阶差≥50 mmHg(1 mmHg=0.133 kPa)的患者,应考虑室间隔心肌切除术(SM)或酒精室间隔消融术(ASA)作为首选治疗方案.本文从HOCM的病理生理学、诊断、药物治疗、SM、ASA以及新兴治疗手段展开,对HOCM治疗进展作一综述.
Objective To investigate the effects of probiotics on readmission rate and trimethylamine oxide(TMAO),a gut microbiota derived metabolite,in patients with heart failure(HF).Methods A total of 100 HF patients from September 2020 to December 2021 in Shaoxing Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into an observation group and a control group,with 50 cases in each group.Both groups were given conventional treatment,while the observation group was also given oral bifidobacterium triple viable capsules.Left ventricular ejection fraction(LVEF),plasma TMAO and N-terminal pro-brain natriuretic peptide(NT-proBNP)were measured.Spearman analysis was used to analyze the relationship between TMAO and NT-proBNP.Readmission rate,LVEF,NT-proBNP and TMAO were compared between the two groups after three months follow-up.Results There was no significant difference in LVEF,TMAO and NT-proBNP between the two groups before treatment(all P＞0.05).TMAO was positively correlated with NT-proBNP(rs=0.523,P＜0.05).At the end of follow-up,there were 44 patients in the observation group and 36 patients in the control group.The readmission rate was 12.00%,significantly lower than 28.00%in the control group(P＜0.05).After treatment,LVEF was significantly higher and TMAO was significantly lower in the observation group than that in the control group(all P＜0.05).NT-proBNP and TMAO decreased and LVEF increased significantly in both groups after treatment(all P＜0.05).Conclusion TMAO level is related to NT-proBNP in HF patients.Probiotics can reduce TMAO,improve cardiac function and reduce readmission rate.
Objective To explore the changes of electrocardiographic QT interval in patients with inflammatory bowel disease(IBD)and its clinical significance.Methods Clinical data of 85 IBD patients in Jinhua Municipal Central Hospital from March 2020 to March 2021 were retrospectively analyzed.According to the severity of the disease,the patients were divided into mild group(34 cases),moderate group(29 cases)and severe group(22 cases).Another 35 healthy subjects were selected as a control group.General data,C-reactive protein(CRP),procalcitonin,erythrocyte sedimentation rate(ESR),QT interval,QT dispersion,QTc dispersion were compared between groups.The association of QT interval changes with inflammatory factors and IBD disease activity index was analyzed,while ECG characteristics were evaluated by ROC curve,the value of QT interval in predicting malignant arrhythmias(MA)within three months were analyzed.Results CRP,procalcitonin,ESR,QT interval,QT dispersion and QTc dispersion were significantly higher in severe,moderate and mild groups than in the control group,in severe group than in moderate and mild groups,and in moderate group than in mild group(all P＜0.05).QT interval,QT dispersion and QTc dispersion were positively correlated with CRP,procalcitonin,ESR and disease activity index(all P＜0.05).The incidence of MA was 14.12%in IBD patients.QT interval,QT dispersion and QTc dispersion were significantly higher in patients with than without MA(all P＜0.05),and were significantly correlated with the occurrence of MA(P＜0.05).The area under the curve(AUC)of QT interval,QT dispersion and QTc dispersion for predicting MA occurrence was 0.701,0.721 and 0.828,respectively,and the AUC of combined three parameters was 0.891.Conclusion QT interval variations are closely related to inflammatory reaction in IBD patients.The risk of MA is higher in patients with significant changes of QT interval.
Objective To investigate the effect of naloxone treatment combined with stepwise decompression on neurological recovery and prognosis in patients with acute severe craniocerebral trauma(ASCCT).Methods One hundred and twenty-five patients with ASCCT admitted to Xinchang Hospital Affiliated to Wenzhou Medical University from September 2017 to September 2020 were selected.Among them,43 patients underwent stepwise decompression and treated with naloxone(observation group).Forty-six cases underwent stepwise decompression(control group A).Thirty-six cases underwent craniotomy hematoma removal and decompressive craniectomy(control group B).Intracranial pressure,serum levels of matrix metalloproteinase-9(MMP-9)and S-100 protein B(S-100B)before and after surgery,as well as Glasgow coma scale(GCS)score,neurobehavioral cognitive status test(NCSE)score,and Barthel index at six months after surgery,as well as the incidence of surgical complications and good outcome scale(Glasgow outcome scale score 1-5)were compared among the three groups.Results There was no statistical difference in intracranial pressure,serum MMP-9 and S-100B among the three groups(all P＞0.05).The intracranial pressure was significantly lower in the observation group than in the control group B immediately after surgery(P＜0.05),and lower than in the control group A and control group B at one week and 6 months after surgery(all P＜0.05).On the 7th day after surgery,serum MMP-9 and S-100B were significantly lower in the observation group than in the control groups A and B(all P＜0.05).The incidence of acute encephalocele,delayed traumatic intracerebral hematoma,delayed contralateral intracerebral hematoma or occipital epidural hematoma,cerebral infarction,and total surgical complications were significantly lower in the observation group than in the control group B(all P＜0.025).At 6 months after surgery,GCS score,NCSE score and Barthel index were significantly higher in the observation group than in the control group A and B(all P＜0.05),and the good outcome rate was significantly higher than that in the control group A and B(all P＜0.025).Conclusion Naloxone treatment combined with stepwise decompression can reduce intracranial pressure,surgical complications,improve neurological function and prognosis in patients with ASCCT.
变异型心绞痛的一过性ST段抬高和(或)T波高耸在常规心电图上很难捕捉,采用动态心电图也有不同程度的误判和漏诊.心电瀑布图为心电图形态信息变化的识别提供了新途径.本文通过2021年6月至2022年11月平湖市第一人民医院4例变异型心绞痛的常规动态心电图分析和动态心电图结合心电瀑布图分析作比较,发现动态心电图结合心电瀑布图方式可提高ST-T异常的检出率,心电瀑布图在分析变异型心绞痛的ST-T异常方面有独特优势.
Objective To investigate the clinical effect of diuretics combined with non-invasive positive pressure ventilation(NIPPV)in the treatment of acute exacerbation of chronic pulmonary heart disease(CPHD).Methods A total of 92 patients with acute exacerbation of CPHD from January 2019 to October 2021 in Quzhou Hospital Affiliated to Wenzhou Medical University were enrolled and randomly divided into an observation group and a control group(with 46 cases in each group).On the basis of routine treatment,the control group was given NIPPV,and the observation group was given NIPPV with diuretics.The curative effect,rehabilitation process,respiratory function and blood gas parameters,end diastolic right ventricular transaction diameter(RVTD)/left ventricular transaction diameter(LVTD),tricuspid annular plane systolic excursion(TAPSE),right ventricular fractional area change(FAC),pulmonary artery systolic pressure(PASP),right ventricular outflow tract(RVOT),left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF)and occurrence of adverse reaction were compared between the groups.Results The total effective rate of the observation group was 95.65%,significantly higher than 82.61%of the control group(P＜0.05).The time to dyspnea relief,lower extremity edema relief,physical recovery,and the length of hospital stay in the observation group were significantly lower than those of the control group(all P＜0.01).After treatment,arterial partial pressure of oxygen in the observation group was significantly higher than that in the control group,and arterial partial pressure of carbon dioxide was lower than that in the control group(all P＜0.05).RVTD/LVTD,PASP,RVOT,LAD,LVEDd and LVESd in the observation group after treatment were significantly lower than those in the control group,and TAPSE,FAC and LVEF were higher than those in the control group(all P＜0.05).The incidence of adverse reactions in the observation group was 6.52%(3/46),compared with 2.17%(1/46)in the control group,with no significant difference(P＞0.05).Conclusion Diuretics combined with NIPPV in the treatment of acute exacerbation of CPHD can improve curative effect,recovery process,respiratory and cardiac function.
Objective To explore the therapeutic efficacy and prognostic factors of endoscopic removal of intracerebral hematoma in elderly patients with hypertensive intracerebral hemorrhage.Methods A total of 122 elderly patients with hypertensive intracerebral hemorrhage admitted to the 72nd Army Hospital of the Chinese People's Liberation Army from November 2018 to November 2021 were selected.Among them,60 patients underwent endoscopic removal of intracerebral hematoma(endoscopy group)and 62 patients underwent craniotomy for hematoma removal(craniotomy group).The surgical conditions,short-term efficacy,intracranial pressure changes,neurological function[evaluated using the neurological deficit score(NDS)],daily life ability[evaluated using the activities of daily living scale(ADL)],postoperative complications,and postoperative 6-month prognosis were compared between the two groups.Multivariate logistic regression analysis was used to identify the factors influencing poor prognosis in the endoscopy group.Results Compared with the craniotomy group,the endoscopy group had significantly shorter operation time,less intraoperative bleeding and postoperative mannitol usage,higher hematoma clearance rate and overall effective rate,with all differences being statistically significant(all P＜0.05).Compared with preoperative values,both groups showed a significant decrease in intracranial pressure at 3 days and 1 week postoperatively,with the endoscopy group exhibiting significantly lower intracranial pressure than the craniotomy group at both time points(all P＜0.05).The postoperative ADL scores at 6 months were significantly higher than the preoperative scores in both groups(all P＜0.05),and the endoscopy group had significantly higher scores than the craniotomy group(P＜0.05).The NDS scores in the endoscopy group decreased significantly at 6 month posoperatively compared to preoperative values(P＜0.05)and was lower than those in the craniotomy group(P＜0.05).The overall incidence of postoperative complica-tions was significantly lower in the endoscopy group than in the craniotomy group(P＜0.05),and the rate of good prog-nosis was significantly higher in the endoscopy group(P＜0.05).A history of hypertension≥10 years(OR=5.417),intraventricular hemorrhage(OR=6.267),CT evidence of hematoma volume≥50 mL on admission(OR=7.022),and Glasgow coma scale(GCS)score before surgery(OR=8.156)were independent factors influencing poor prognosis in the endoscopy group(all P＜0.05).Conclusion Endoscopic removal of intracerebral hematoma in elderly patients with hypertensive intracerebral hemorrhage has significant therapeutic efficacy.It can improve hematoma clearance rate,reduce intracranial pressure,and decrease mannitol usage.Clinically,targeted diagnostic and therapeutic interventions can be timely implemented based on factors such as the history of hypertension,intraventricular hemorrhage,CT evidence of hematoma volume on admission,and preoperative GCS score to improve patient prognosis.
Objective To investigate the risk factors of early disease progression in patients with mild ischemic stroke.Methods Clinical data of 135 patients with mild ischemic stroke treated in Yiwu Central Hospital from March 2019 to November 2021 were retrospectively analyzed.According to disease development,33 cases were divided into observation group and 102 cases were divided into control group.General data of the two groups were compared.Logistic regression was used to analyze the influencing factors of early disease progression in mild ischemic stroke,and ROC curve was used to analyze the value of serological indicators in predicting early disease progression.Results The proportion of hypertension,diabetes,abnormal circadian rhythm of blood pressure,multiple lesions and complicated acute infection,uric acid,Hcy and D-dimer were significantly higher in observation group than in control group(all P＜0.05).Logistic regression analysis showed that abnormal circadian rhythm of blood pressure,multiple lesions,Hcy and D-dimer were the main factors affecting early disease progression(P＜0.05).ROC curve analysis showed that the value of Hcy combined with D-dimer in predicting early disease progression of mild ischemic stroke was higher than that of Hcy or D-dimer alone.Conclusion Abnormal circadian rhythm of blood pressure,multiple lesions,high level of Hcy and D-dimer may increase the risk of early disease progression of mild ischemic stroke.
Objective To explore the characteristics of cognitive impairment in bipolar disorder(BD)patients with depression as the leading symptom and its correlation with cerebral blood perfusion.Methods A total of 131 BD patients with depression as the leading symptom who were treated in Wenzhou Seventh People's Hospital from September 2017 to October 2020 were selected as the research subjects,including 30 cases in Frank clinical stage Ⅱ,51 cases in stage Ⅲ and 50 cases in stageⅣ.The Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),MATRICS consensus cognitive battery(MCCB)[trail making test A(TMT-A),symbol coding(SC),animal naming test(AFT),Hopkins verbal learning test-revised(HVLT-R),continuous performance test-identical pairs version(CPT-IP),neurop-sychological assessment battery(NAB),mayer-salovey-caruso emotional intelligence test(MSCEIT),Wechsler memory scale-Ⅲ(WMS-Ⅲ)and brief visuospatial memory test-revised(BVMT-R)]scores,and changes in cerebral blood perfusion were compared among patients at different Frank clinical stages.The correlation between changes in cerebral blood perfusion and MCCB scores was analyzed.Results There were statistically significant differences among patients in different Frank clinical stages in terms of the total score of HAMA,the scores for physical anxiety and mental anxiety,the total score of HAMD,the scores for somatization/anxiety,change from day to night and sleep disorders(all P<0.05).Above scores decreased in sequence from stage Ⅱ,stage Ⅲ to stage Ⅳ(all P<0.05).There were statistically significant differences among patients in different Frank clinical stages in terms of the scores for TMT-A,SC,AFT,HVLT-R,CPT-IP,NAB,MSCEIT,WMS-Ⅲ and BVMT-R(all P<0.05),and the scores decreased in sequence from stage Ⅱ,stage Ⅲ to stage Ⅳ(all P<0.05).Differences in the enhancement ratio of perfusion in the left basal ganglia,right basal ganglia,as well as the reduction ratio of perfusion in the left temporal lobe,right temporal lobe,left frontal lobe,and right frontal lobe were statistically significant among patients in different Frank clinical stages(all P<0.05).The proportions of patients in stage Ⅲ and stage Ⅳ were significantly higher than those in stage Ⅱ(all P<0.05).Among all patients,there was a positive correlation between the enhancement ratio of perfusion in the right basal ganglia and BVMT-R score(rs=0.412,P<0.05),and a negative correlation between the reduction ratio of perfusion in the left frontal lobe and BVMT-R score(rs=-0.433,P<0.05).Conclusion With the progression of staging in BD patients with depression as the leading symptom,cognitive impairment aggravates gradually.Enhanced perfusion of the right basal ganglia is positively correlated with the BVMT-R score,and decreased perfusion of the left frontal lobe is negatively correlated with the score.
Acute coronary syndrome(ACS)has a high morbidity and mortality rate,and diagnosis is still limited by the lagging,invasive,and costly nature of the tests.Artificial intelligence(AI)technology is widely used in the field of cardiovascular disease,and it plays a unique advantage in processing large and complex data,and its application to the diagnosis and treatment of ACS can improve efficiency and accuracy.In this paper,researchers review the application of AI technology in the diagnosis,early warning and prognostic assessment of ACS.
心电图显示ST段抬高的患者,结合典型临床症状及实验室检查,可诊断为心肌梗死,但仍有部分患者虽符合以上标准,冠状动脉(下称冠脉)造影或其他相关检查却不支持心肌梗死,如心室早复极、应激性心肌病、肥厚型心肌病、肺动脉栓塞、Brugada波、急性心包炎、重症心肌炎等.本研究收集 2021年11月至2023年9月义乌市中心医院非心肌梗死心电图ST段抬高患者6例,结合临床病史、超声心动图、冠脉造影、实验室检查等进行分析,探讨 6例患者心电图特征动态演变规律及ST段抬高的病因.临床医生应熟悉各种类型ST段抬高心电图改变,结合临床指标,仔细鉴别,减少误诊或漏诊.
Objective To explore the interaction effect of heart rate variability(HRV)and brain natriuretic peptide(BNP)on diabetes nephropathy(DKD).Methods One hundred and five patients with diabetes admitted to Hangzhou Hospital of Traditional Chinese Medicine from January 2016 to October 2021 were included.Among them,32 cases had DKD(observation group),73 cases had no DKD(control group).The general data,HRV[root mean square differences of successive RR intervals(rMSSD),standard deviation of normal-to-normal intervals(SDNN),percentage of successive normal-to-normal interval differences larger than 50 ms(PNN50),low frequency/high frequency],brain natriuretic peptide(BNP)and Mogensen stage were compared between the two groups.Logistic regression was used to analyze influencing factors of renal damage in diabetes patients.Interaction analysis was used to analyze the interaction effect of HRV and BNP on DKD.Results rMSSD,SDNN,PNN50,and low-frequency/high-frequency were significantly lower while NBP was significantly higher in the observation group than in the control group(all P＜0.05).The Mogensen stage was better in the observation group than in the control group(P＜0.05).The Mogensen stage was better in patients with abnormal HRV than in patients with normal HRV,and in patients with abnormal BNP than in patients with normal BNP(P＜0.05).Logistic regression analysis showed that rMSSD,SDNN,PNN50,low-frequency/high-frequency,and BNP were influence factors of DKD(all P＜0.05).HRV and BNP had a positive interaction effect on DKD,which was consistent with multiplicative model.Conclusion Abnormal HRV and BNP have a positive interaction effect on DKD.
Objective To analyze the risk factors of chronic obstructive pulmonary disease(COPD)combined with cor pulmonale and construct a nomogram model.Methods A total of 52 patients with COPD complicated with cor pulmonale from June 2018 to June 2021 admitted to the General Hospital of Shaoxing Second Hospital Medical Community were selected as an observation group,while 52 patients with pure COPD at the same time were selected as a control group.The clinical data were collected,included serum brain natriuretic peptide(BNP),C-reactive protein,echocardiography parameters,artery blood gas parameters measured within 24 h after admission.Multivariate logistic analysis was used to determine risk factors for cor pulmonale.A nomogram model was established based on the risk factors,and the predictive performance of the nomogram model was evaluated.Results COPD duration,smoking time,BNP and partial pressure of carbon dioxide were significantly higher in the observation group than in the control group(all P＜0.05).Multivariate analysis showed that COPD duration＞10 years、BNP＞193.58 ng/mL and right atrium(RA)＞39.4 mm were the risk factors for cor pulmonale(all P＜0.05).The C index of nomogram model for predicting COPD with cor pulmonale was 0.796(95%CI:0.514-0.973).When the risk threshold was greater than 0.25,the nomogram model exhibited better predictive performance than using COPD,BNP,or RA alone.Conclusion COPD duration,BNP and RA are the risk factors for cor pulmonale.Nomogram model is benefit to predict cor pulmonale development.
