射血分数正常的心力衰竭患者临床及超声指标特点分析  

Clinical and Echocardiographic Characteristics of the Cardiac Failure Patients with Normal Ejection Fraction

作　　者：李诗文[1] 杨军[1] 李潭[1] 邱悦[1] 马玥[1] 关莹莹[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳110001

出　　处：《中国医科大学学报》2013年第12期1109-1112,共4页Journal of China Medical University

基　　金：沈阳市科学技术计划(F12-193-9-19);高等学校博士学科点专项基金(20112104110010)

摘　　要：目的探讨射血分数正常的心力衰竭患者临床及超声指标特点。方法选取2010年9月至2011年9月于我院心内科住院诊断为心功能不全且资料完整患者310例,分为射血分数正常组(HFNEF)及减低组(HFREF),选取健康人92例作为对照组,检测临床及超声多项指标。结果(1)HFNEF组女性比例及女性平均年龄均较HFREF组大(P<0.05);(2)2组心力衰竭患者收缩压、总胆固醇、脑钠肽(BNP)、左心房及左心室内径、左心室舒末容积、二尖瓣口E/A值、A值、室间隔及左心室后壁厚度差异有统计学意义(P<0.05);(3)2组心力衰竭患者BNP均随NYHA分级升高而增加(r_1=0.201,P_1=0.018;r_2=0.413,P_2=0.000),与左室射血分数呈负相关(r_1=-0.204,P_1=0.014;r_2=-0.463,P_2=0.000),与左心房前后径呈正相关(r_1=0.267,P_1=0.002;r_2=0.179,P_2=0.031),与左心室前后径呈正相关(r_1=0.332,P_1=0.000;r_2=0.314,P_2=0.000)。结论脑钠肽、血压、胆固醇等临床指标与超声指标相结合能够为HFNEF的诊断及病情评估提供重要依据。Objective To investigate the clinical and echocardiographic parameter characteristics of the cardiac failure patients with normal ejec- tion fraction. Methods Three hundred and ten cardiac failure patients who were hospitalized in department of cardiology in our hospital between Sep. 2010 and Sep. 2011 and 92 control subjects were enrolled for the study, the indices of clinic and echocardiography were measured. The heart failure patients were divided into normal group （HFNEF） and reduction （HFREF） in accordance with the ejection fraction. Results （ 1 ） The fe- male proportion and female average age of HFNEF group were both higher than HFREF group （P 〈 0.05 ） ; The proportion of hypertension and coro- nary heart disease in HFNEF group was higher than HFREF group. （2） Systolic blood pressure, TC, BNP, LAD, LVD, EDV, E/A, A, IVST, LVP- WT between the two heart failure groups were statistically significant （P 〈 0.05 ）. （3） In two cardiac failure groups, BNP levels were positively corre- lated with the severity of NYHA class （r1=0.201, P, =0.018 ; r2 =0.413, P2 =0.000 ）. In addition, the BNP levels were negatively correlated with the LVEF （r1=-0.204, P, =0.014 ; r2 =-0.463, P1=0.000） and positively correlated with LAD （r1=0.267, P1=0.002 ; r2 =0.179, P2 =0.031 ） and LVD （r1= 0.332, P1 =0.000 ; r2 =0.314, P2 =0.000）. Conclusion The eombination of clinical parameters （ such as BNP, blood pressttre and TC ） with eehoear- diographie parameters is important in diagnosis and severity evaluation of HFNEF.

关 键 词：心力衰竭 射血分数 超声心动图描记术 脑钠肽 诊断 

分 类 号：R541.6[医药卫生—心血管疾病]