心力衰竭超声指数对心脏瓣膜病变患者的整体心功能评价中的应用价值  

Heart Failure Echocardiography Index on the Cardiac Function Overall Evaluation of Patients with Heart Valve Disease

作　　者：马逸宜[1] 蒋燕东[1] 朱栋晓[1] 刘小铭[1] 施晶晶[2] 陈冲昊[2] 

机构地区：[1]无锡市第三人民医院超声诊断科,江苏无锡214041 [2]无锡市第三人民医院心内科,江苏无锡214041

出　　处：《中国血液流变学杂志》2015年第3期292-296,共5页Chinese Journal of Hemorheology

摘　　要：目的：探讨多项超声心动图参数的心力衰竭超声指数对心脏瓣膜病变患者整体心功能评价中的应用价值，为心脏瓣膜病患者病程中对心功能的影响因素分析提供客观、全面的临床指标。方法选取2014年5月—2015年7月收治的患有心脏瓣膜病变的120例患者作为研究对象，其中左心室射血分数（LVEF）高于50%者有76例，而低于50%者有44例，同时选取健康志愿者40名作为正常对照组，而选取非瓣膜性病变的40例心力衰竭患者为非瓣膜病变对照组。所有受试者均采用多项超声心动图参数的心力衰竭超声指数进行打分，将此分数与同期测定的血浆脑钠素（BNP）水平、Tei指数和纽约心功能分级标准进行对比，分析心衰超声指数对心脏瓣膜病变患者心衰诊断的特异性、敏感性、阳性预测值和阴性预测值；探讨其与血浆BNP水平及纽约心功能分级标准的相关性；分析瓣膜病变不同程度瓣膜因素对患者整体心功能的影响。结果观察组患者的心衰超声指数明显高于正常对照组（P﹤0.01），且随纽约心功能分级升高而增大；心功能Ⅱ级、Ⅲ级和Ⅳ级患者的心衰超声指数经统计分析，差异具有统计学意义（P﹤0.05），经过相关性分析，观察组患者的心衰超声指数与其血浆BNP具有明显的相关性（P﹤0.05）。结论将心力衰竭超声指数与血浆BNP水平、Tei指数及纽约心功能分级标准联合用于对心脏瓣膜病变患者的整体心功能进行评价具有较高的应用价值，可在临床上推广应用，在瓣膜病变过程中，瓣膜因素可作为心衰的影响因素之一。Objective To investigate the application value of heart failure echocardiography index （HFEI） of multiple echocardiographic parameters on the overall cardiac function evaluation of patients with heart valve, so as to provide objective and comprehensive clinical indicators for the cardiac function risk factors of heart valve patients during the course.Methods 120 patients with heart valve disease that admitted by hospital from May 2014 to July 2015 were selected as research objects, of which 76 patients＇ LVEF value were greater than 50%, and 44 patients＇ were lower than 50%. At the same time, 40 cases of healthy volunteers were selected as normal control group while 40 cases of non-valvular lesion but with heart failure patients were selected as disease control group. All subjects were scored according to the HFEI of multiple echocardiographic parameters, and then the scores will be compared with brain natriuretic peptide （BNP） level, Tei index and the New York Heart Association （NYHA） functional class standard that was measured at the same period to analyze the specificity, sensitivity, positive predictive value and negative predictive value of HFEI on the heart failure diagnosis of patients with heart valve disease, discuss its correlation with BNP level and NYHA functional class standard, and analyze the infl uence of different degree of valvular disease on the overall heart function of patients.Results The HFEI in observation group was signifi cantly higher than the normal control group （P﹤0.01）, and it is increase along with the increasing of NYHA functional class; there is a signifi cant difference of HFEI among cardiac function classⅡ,Ⅲ andⅣ patients by statistics analysis （P﹤0.05）, after correlation analysis, the HFEI and plasma BNP were signifi cantly correlated in observation group （P﹤0.05）.Conclusion The joint application of HFEI, plasma BNP level, Tei index and NYHA standard have a high application value on patients with valvular heart disease in regards of overa

关 键 词：超声心动图 心脏瓣膜病变 心衰超声指数 血浆脑钠素 纽约心功能分级 

分 类 号：R541.61[医药卫生—心血管疾病]