血清白蛋白水平评价慢性心力衰竭患者心脏再同步化治疗的初步探讨  

Preliminary Effect for Serum Albumin Level Evaluating the Patients With Chronic Heart Failure Treated by Cardiac Resynchronization

作　　者：张兴通[1] 赵鹃[1] 王淼[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江省哈尔滨市150001

出　　处：《中国循环杂志》2015年第4期343-345,共3页Chinese Circulation Journal

基　　金：黑龙江省卫生厅课题(No.2005-205);黑龙江省留学归国科学基金(LC2011C13)

摘　　要：目的：利用血清白蛋白（ALB）水平评估慢性心力衰竭（心衰）患者心脏再同步化治疗（CRT）的疗效。方法：选择2009-01至2013-12于我院行CRT的慢性心衰患者27例（CRT组），同时连续选取药物治疗的慢性心衰患者27例（对照组）。分组后所有患者进行血液生化指标的检测、体表心电图、24 h动态心电图和超声心动图检查，记录血清白蛋白（ALB）水平、心率、心电图QRS波时限、左心室舒张末期内径（LVED）及左心室射血分数（LVEF），检测结果作为入院时基础值；定期随访，随访期间重复上述检查2-3次，取均值。结果：两组患者在分组时年龄、性别等一般资料差异无统计学意义。随访时CRT组ALB、LVEF较入院时基础值升高（P〈0.05），心率下降（P〈0.001），QRS波时限缩短（P〈0.001），LVED变化不明显；对照组ALB较入院时基础值下降（P〈0.05），LVEF、LVED、QRS波时限、心率无明显变化，对CRT组P〈0.05的指标即LVEF、QRS时限、血清ALB水平进行逐步Logistic回归分析，筛选出血清ALB水平是CRT疗效最为相关的指标（P〈0.01）。结论：CRT可以改善心室收缩功能，提高慢性心衰患者血清白蛋白水平，推测血清ALB水平与CRT疗效具有一定相关性。Objective： To evaluate the preliminary effect for serum albumin （ALB） level in patients with chronic heart failure （CHF） treated by cardiac resynchronization （CRT）. Methods： A total of 54 CHF patients treated in our hospital from 2009-01 to 2013-12 were studied. The patients were divided into 2 groups： CRT group and Control group, in which the patients were treated by medication. n=27 in each group. The blood test of biochemistry, 24 hour dynamic ECG monitoring with QRS duration, echocardiography, ALB level, heart rate （HR）, left ventricular end-diastolic dimension （LVEDD） and left ventricular ejection fraction （LVEF） were recorded at admission as baseline information, and the above examinations were repeated 2 to 3 times during 6-15 months of follow-up period. Results： The age, gender and baseline information were similar between 2 groups. Compared with admission, during followed-up period, CRT group had increased ALB, LVEF, P〈0.05, decreased HR, P〈0.001, shorter QRS duration, P〈0.001 and LVED remained similar;while Control group had decreased ALB, P〈0.05 and LVEF, LVED, QRS duration, HR remained similar. Logistic regression analysis indicated that in CRT group, with adjusted LVEF, QRS duration and ALB, serum ALB level was the most relevant indicator for CRT efifcacy, P〈0.01. Conclusion： CRT could improve the cardiac function and increase ALB in CHF patients, therefore serum ALB level might be related to CRT efifcacy at certain degree.

关 键 词：心脏再同步化 慢性心力衰竭 血清白蛋白 左心室射血分数 左心室舒张末期内径 

分 类 号：R54[医药卫生—心血管疾病]