采用超声心动图参数分析和预测慢性左心室射血分数降低心力衰竭患者1年内再入院风险  

Analysis and Prediction for 1 Year Re-admission Risk in Patients of Chronic Heart Failure With Reduced Left Ventricular Ejection Fraction by Echocardiography

作　　者：王晓军[1] 丛晓[2] 申晓倩 徐良栋[4] 王艺丹[1] 胡和生[1] 闫素华[1] 郝恩魁[1] 

机构地区：[1]山东大学附属千佛山医院心内科,山东省济南市250014 [2]济南市中心医院心内科 [3]烟台毓璜顶医院神经外科监护室 [4]潍坊医学院

出　　处：《中国循环杂志》2016年第2期142-145,共4页Chinese Circulation Journal

基　　金：2014年山东省科技发展计划(2014GSF118187)

摘　　要：目的：采用超声心动图参数分析和预测慢性左心室射血分数（LVEF）降低心力衰竭（HFrEF）1年内再入院风险。方法：入选2007—1至2008—12期间我院慢性HFrEF患者313例，随访6～7年，以1年内再入院为本研究的终点。313例患者均接受常规超声心动图检查，检测参数包括LVEF、左心室内径、肺动脉收缩压、二尖瓣反流、三尖瓣反流、心包积液6项指标，并依据6项指标分组，对HFrEF患者1年内再入院进行分析。结果：单因素分析发现，二尖瓣反流、三尖瓣反流和心包积液对心力衰竭患者1年内再入院时间有较好的预测价值：二尖瓣反流[风险比（HR）=1．437，95％可信区间（CI）：1．190～1．737，P=0．000），三尖瓣反流（HR=1．288，95％CI：1．056—1．572，P=0．013），心包积液（HR=1．560，95％CI：1．050～2．318，P=0．028）。采用多因素分析发现，二尖瓣反流（HR=1．404，95％CI：1．159～1．701，P=0．001）对心力衰竭患者预测价值最大，其次为心包积液（HR=1．410，95％CI：1．030～1．928，P=0．032）。结论：二尖瓣反流、三尖瓣反流、心包积液均为1年内再入院的特异指标，Cox分析显示二尖瓣反流、心包积液为预测1年内再入院的独立危险因素。Objective： To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction （HFrEF） by echocardiography. Methods： A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for （6-7） years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of （LVEF）, left ventricular diameter （LVd）, pulmonary artery systolic pressure （PASP）, mitral regurgitation （MR）, tricuspid regurgitation （TR） and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed. Results： Univariate analysis indicated that MR （HR=1.437, 95% CI 1.190-1.737, P=0.000）, TR （HR=1.288, 95% CI 1.056-1.572, P=0.013） and pericardial effusion （HR=1.560, 95% CI 1.050-2.318, P=0.028） had better predictive value for 1 year re-admission. Multivariate analysis presented that MR （HR=l.404, 95% CI 1.159-1.701, P=0.001） took first place for predicting the 1 year re- admission and pericardial effusion took second place （HR=1.410, 95% CI 1.030-1.928, P=0.032）. Conclusion： MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients; while MR and pericardial effusion were the independent risk factors for 1 year re-admission.

关 键 词：心力衰竭 超声心动描记术 COX分析 

分 类 号：R541[医药卫生—心血管疾病]