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目的：研究心电图QRS波时限联合血清巨噬细胞炎症蛋白-1α（MIP-1α）、半乳糖凝集素-3（galectin-3）对慢性心力衰竭（CHF）患者预后的评估价值。方法：选择2022年1月至2023年1月在我院接受治疗的150例CHF患者。检测CHF患者QRS波时限、血清MIP-1α及galectin-3水平。随访12个月，根据预后的不同情况分为预后良好组、预后不良组。采用多因素Logistic回归分析CHF患者预后的影响因素。采用受试者工作特征（ROC）曲线分析血清MIP-1α、galectin-3水平、QRS波时限单独及联合检测对CHF患者预后的评估价值。结果：随访12个月，150例CHF患者中48例发生预后不良（预后不良组），102例预后良好（预后良好组）。预后不良组的QRS波时限、血清MIP-1α及galectin-3水平较预后良好组更高（P＜0.05）。预后不良组的收缩压（SBP）及纽约心脏病协会（NYHA）分级Ⅳ级占比较预后良好组更高，左心室射血分数（LVEF）较预后良好组更低（P＜0.05）。NYHA分级Ⅳ级、QRS波时限延长、血清MIP-1α水平升高、血清galectin-3水平升高均为CHF患者预后不良的危险因素，LVEF升高为保护因素（P＜0.05）。QRS波时限、血清MIP-1α及galectin-3对评估CHF患者预后的曲线下面积（AUC）分别为0.532、0.579、0.603，三项指标联合评估CHF患者预后的AUC为0.857，较各项单独检测更高。结论：心电图QRS波时限延长、MIP-1α和galectin-3水平升高均可能导致CHF患者预后不佳，且这三项指标联合检测可有效评估CHF患者预后

英文摘要:

Objective: To investigate the prognostic value of electrocardiogram QRS duration combine with serum macrophage inflammatory protein-1α (MIP-1α) and galectin-3（galectin-3） in patients with chronic heart failure (CHF). Method: 150 CHF patients who received treatment in our hospital from January 2022 to January 2023 were selected. QRS duration, serum MIP-1 α and galectin-3 levels in CHF patients were detected. Follow up for 12 months, the patients were divided into good prognosis group and poor prognosis group according to their different prognoses. The influence factors of prognosis of CHF patients were analyzed by multivariate logistic regression analysis. The prognostic evaluation value of serum MIP-1α, galectin-3 levels and QRS duration detection alone or in combination for CHF patients was analyzed by receiver operating characteristic (ROC) curve. Result: Follow up for 12 months, 48 out of 150 CHF patients had poor prognosis (poor prognosis group) and 102 had good prognosis (good prognosis group). The QRS duration, serum MIP-1α and galectin-3 levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). systolic blood pressure (SBP), proportion of New York Heart Association (NYHA) Grade IV classification in the poor prognosis group were higher than those in the good prognosis group, elevated left ventricular ejection fraction (LVEF) was lower than that in the good prognosis group(P<0.05). NYHA Grade IV classification, QRS duration extend, elevated MIP-1α and elevated galectin-3 were risk factors for poor prognosis of CHF patients, LVEF was protect factors (P<0.05). The area under the curve (AUC) of QRS duration, serum MIP-1α and galectin-3 for evaluating the prognosis of CHF patients were 0.532, 0.579 and 0.603, respectively, the AUC of the combined evaluation of these three indicators for CHF patient prognosis was 0.857, which was higher than that of each individual detection. Conclusion: Electrocardiogram QRS duration extend and elevated MIP-1α and elevated galectin-3 may lead to poor prognosis of CHF patients, and the combined detection of these three indicators can effectively evaluate the prognosis of CHF patients.

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