中老年人颈动脉硬化与左室射血分数正常的心力衰竭的关联性  

Association of carotid atherosclerosis and heart failure with normal left ventricular ejection fraction in middle-aged and elderly population

作　　者：任飞[1] 梁冬科[1] 余陆娇[1] 王春雷[1] 

机构地区：[1]中国医科大学附属第一医院老年病科,辽宁沈阳110001

出　　处：《心脏杂志》2015年第5期592-595,共4页Chinese Heart Journal

摘　　要：目的研究中老年患者颈动脉硬化与左室射血分数(LVEF)正常的心力衰竭(HFNEF)的关联性,并探讨中老年患者HFNEF早期预测因素。方法收集在我院住院的有心衰高危因素的中老年患者344名,按有无HFNEF分为2组:HFNEF组和无心功能异常组(NHF),对两组患者一般临床资料、血脂、脑钠尿肽(BNP)、血肌酐、肾小球滤过率(GFR)、LVEF、颈动脉硬化、颈动脉斑块积分、左心室质量指数(LVMI)等进行单因素分析及多因素logistic回归分析。结果 logistic回归分析显示HFNEF独立相关的因素有颈动脉硬化、糖尿病、LVMI,GFR,其中颈动脉硬化、糖尿病、LVMI为独立危险因素(OR值分别为3.46、2.45和1.08,均P<0.01),而GFR是保护因素(OR值0.98,P<0.05)。结论颈动脉硬化是中老年HFNEF的独立危险因素。AIM To study the association of carotid atherosclerosis and heart failure with normal left ventricular ejection fraction （HFNEF） in middle-aged and elderly populations and discuss early predictors of HFNEF. METHODS A total of 344 middle-aged and elderly in-patients [ mean age （62 ± 9 ） years ] were divided into two groups： HFNEF group or normal heart function （NHF） group whose clinical data were collected such as general condition, medical history, serum lipid, BNP, serum ereatinine, GFR, LVEF, carotid atheroselerosis, carotid plaque, Crouse score, LVMI, etc. Univariate analysis and logistic regressive analysis were carried out. RESULTS Logistic regressive analysis of HFNEF showed that after adjusting for other factors, carotid atherosclerosis （ OR 3.46, P 〈 0. 01 ）, diabetes mellitus （ DM, OR 2. 45, P 〈 0. 01 ）, LVMI （ OR 1.08, P 〈 0. 01 ） were independent risk factors for HFNEF and the most significant predictor of HFNEF is carotid atherosclerosis. CONCLUSION This study showed HFNEF is associated with carotid atherosclerosis. Carotid atherosclerosis is a significant risk predictor of HFNEF in middle-aged and elderly patients.

关 键 词：心力衰竭 左室射血分数 颈动脉硬化 左心室质量指数 心肌重构 

分 类 号：R541.6[医药卫生—心血管疾病]