无创动脉僵硬度检测对评价慢性心力衰竭患者心功能不全的意义  

Noninvasive arterial stiffness examination evaluates cardiac insufficiency in patients with chronic heart failure

作　　者：夏小琦[1] 杨成明[1] 曾春雨[1] 王旭开[1] 方玉强[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心血管内科,重庆400042

出　　处：《第三军医大学学报》2009年第24期2466-2468,共3页Journal of Third Military Medical University

摘　　要：目的探讨应用动脉僵硬度检测仪评估动脉硬化程度的临床价值及慢性心力衰竭(chronic heart failure,CHF)患者心功能不全的意义。方法选择本科110例CHF患者,根据NYHA心功能分级分为Ⅱ、Ⅲ、Ⅳ级组。测量患者的心-踝血管指数(CAVI)、踝臂指数(ABI)、左室射血分数(LVEF)、抽静脉血查血浆醛固酮(ALD)、B型脑钠肽(BNP)及高敏C反应蛋白(Hs-CRP)浓度,并进行相关性分析。结果心功能Ⅲ级组、Ⅳ级组右侧肢体CAVI(CAVI-R)和左侧肢体CAVI(CAVI-L)较Ⅱ级组明显升高(P<0.05)。心功能Ⅲ级组、Ⅳ级组血浆ALD、BNP、Hs-CRP较Ⅱ级组明显升高(P<0.05)。心功能Ⅲ级组、Ⅳ级组LVEF较Ⅱ级组明显降低(P<0.05)。CAVI与ALD、BNP、Hs-CRP呈正相关(r=0.344,r=0.434,r=0.406,P<0.05),与LVEF呈负相关(r=-0.678,P<0.05)。结论CAVI与ABI同样有评估动脉硬化程度的临床价值,并具有简便、可靠、无创性的优点;CAVI与传统的指标具有很好的相关性,可作为评估CHF患者心功能的指标。Objective To investigate the significance of noninvasive arterial stiffness examination in patients with chronic heart failure （CHF）. Methods A total of 110 patients with chronic heart failure and ad- mitted in our hospital from October 2008 to January 2009 were subjected in this study. They were divided into 3 groups according to their cadiac function varied from class Ⅱ - Ⅳ （NYHA）. There were 50 patients in NYHA Ⅱ group, 30 in Ⅲ group, and 300 in Ⅳ group. Measurement of these parameters, including the cardio-ankle vascular index （CAVI）, ankle-brachial index （ABI）, left ventricular ejection fraction （LVEF）, plasma aldo- sterone （ALD）, B-type natriuretic peptide （BNP）, high sensitive reaction protein C （Hs-CRP） were measured, and the relationship among these parameters were analyzed. Results CAVI in m group and IV group was obviously higher than that in group Ⅱ（ P 〈 0. 05 ）. Plasma ALD, BNP and Hs-CRP were significantly higher in the group Ⅲ and group Ⅳ than in group Ⅱ （ P 〈 0.05 ）. Color Doppler echocardiography indicated that group Ⅲ and group Ⅳ had obviously decreased LVEF compared with the group Ⅱ （P 〈 0. 05 ）. CAVI was positively correlated with ALD, BNP and Hs-CRP respectively （ r = 0. 344, 0. 434, 0. 406, P 〈 0.05 ） , and negatively correlated with LVEF（r = - 0. 678, P 〈 0.05 ）. Conclusion CAVI and ABI have equal value to evaluate arteriosclerosis degree. But the former is simple, reliable and non-invasive, and makes more comprehensive evaluation in cardiac function for cardiac patients with CHF and has the sound correlation with the traditional non-invasive indexes.

关 键 词：动脉硬化 慢性 心力衰竭 心-踝血管指数 踝臂指数 

分 类 号：R331.31[医药卫生—人体生理学] R540.4[医药卫生—基础医学]