床边肺部超声肺淤血分级对ST段抬高型心肌梗死合并肺淤血患者院内不良预后的预测价值
Predictive complicated by value of bedside pulmonary ultrasound in hospital death of patients with ST-segment elevation myocardial infarction

李珊.床边肺部超声肺淤血分级对ST段抬高型心肌梗死合并肺淤血患者院内不良预后的预测价值[J].内科急危重症杂志,2026,32(3):250-253

DOI：10.11768/nkjwzzzz20260309

英文关键词:Pulmonary ultrasound Myocardial infarction Prediction

基金项目:

作者	单位	E-mail
李珊	湖北省十堰市妇幼保健院超声医学科	307052832@qq.com

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中文摘要:

摘要目的：评估床边肺部超声检测（LUS）对ST段抬高型心肌梗死(STEMI)合并肺淤血患者院内死亡的预测价值。方法：对243例STEMI患者经皮冠状动脉介入治疗(PCI)前进行LUS和Killip分级。根据是否并发肺淤血，分为肺淤血组和非肺淤血组。比较分析2组患者的临床资料。采用受试者工作特征曲线（ROC）分析肺淤血分级及Killip分级对STEMI患者院内死亡的预测价值。结果：Logistic回归分析显示：年龄、性别、左室射血分数（LVEF）、肺淤血分级、Killip分级均是其影响因素（P均＜0.05）。其中有肺淤血的STEMI患者死亡风险是无肺淤血者的4.813倍。Killip≥Ⅲ级STEMI患者死亡风险是Killip≤Ⅱ级患者的3.474倍。ROC分析显示： LUS检测肺淤血分级、Killip分级及两指标联合应用预测STEMI患者院内死亡的曲线下面积分别为0.756（95%Cl:0.600～0.953）、0.714（95%Cl:0.566～0.900）、0.785（95%Cl:0.628～0.981）。结论：LUS检测肺淤血分级结合Killip分级对STEMI患者不良预后有预测价值。

英文摘要:

Abstract Objective: To evaluate the predictive value of bedside lung ultrasound （LUS） for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) complicated by pulmonary congestion. Methods: A total of 243 STEMI patients underwent LUS and Killip classification before percutaneous coronary intervention （PCI）. Based on the presence or absence of pulmonary congestion, they were divided into a pulmonary congestion group and a non-pulmonary congestion group. Clinical data of both groups were compared and analyzed. The predictive value of pulmonary congestion grading and Killip classification for in-hospital mortality in STEMI patients was assessed by receiver operating characteristic curve analysis. Results: Logistic regression analysis revealed that age, gender, left ventricular ejection fractions(LVEF), pulmonary congestion grading, and Killip classification were all significant influencing factors (all P< 0.05). Patients with pulmonary congestion had a 4.813-fold higher risk of mortality than those without pulmonary congestion. Patients with Killip ≥ III had a 3.474-fold higher risk of mortality than those with Killip ≤ II. ROC analysis showed the areas under the curve for predicting in-hospital mortality in STEMI patients were 0.756 (95%CI: 0.600-0.953) for LUS-based pulmonary congestion grading, 0.714 (95%CI: 0.566-0.900) for Killip classification, and 0.785 (95%CI: 0.628-0.981) for the combined use of both indicators. Conclusion: LUS-based pulmonary congestion grading combined with Killip classification has predictive value for adverse outcomes in STEMI patients.