老年人心力衰竭与肝、肾功能、血脂变化的相关性  

The correlation between heart failure levels and changes of liver function, renal function and blood lipids in elderly patients

作　　者：房加雄 郁鹏[1,3] 于慧春 郝媛媛 徐海丽[4] 李贺[1,3] 

机构地区：[1]武警后勤学院附属医院老年病科,天津300162 [2]武警部队第41师714团卫生队,云南蒙自661100 [3]天津西青医院老年病科,天津300380 [4]武警北京总队医院老年病科,北京100027

出　　处：《武警后勤学院学报（医学版）》2016年第9期709-713,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】研究老年人心力衰竭(heart failure,HF)与多器官功能异常的关系。【方法】连续观察150例住院治疗的不同心功能HF患者心、肝、肾脏功、血脂等变化,分析这些变化与HF心功能间关系。【结果】随心功能减退:(1)HFr EF所占比例从心功能II级至IV级由16.00%增加至58.33%,LAD、LVED、RAD、RVD显著增加、NT-pro BNP、c Tn I水平升高。(2)肝、肾功能、脂代谢异常患者在各组中所占比例明显升高。(3)心功能IV级组血尿酸水平升高患者达54.17%。【结论】随心功能减退,出现显著心脏重塑,肝、肾功能下降、脂代谢异常;在HF进展过程中,LDL、HDL异常变化发挥的作用可能与传统认识不同,应进一步研究阐明。[Objective]To study the relationship between heart failure （HF） and multi-organ dysfunction in elderly patients. [ Methods ] A total of 150 HF inpatients in different levels of cardiac function were consecutively observed on the changes of cardiac function, liver function, renal function and blood lipids. The relationship was analyzed between these changes and cardiac function of HF. [ Resuits] With the decline of cardiac function, （1） the HFrEF proportion increased from 16.00% to 58.33% when cardiac function in- creased from II to IV; left atrial diameter （LAD）, left ventricular end diastolicdeameter （LVED）, right atrial diameter （RAD） and right ventricular end diameter （RVD） increased significantly; the levels of NT-proBNP and cTnI rose. （2） The ratios of patients with liver dys- function, renal dysfunction and lipid abnormalities obviously increased in each group. （3） Hyperurieemia occurred in 54.17% patients in the group with cardiac function class IV. [ Conclusion ] With the decline of cardiac function, significant cardiac remodeling occurs and liver function, renal function and lipid metabolism decline. In the progress of HF, the role of LDL and HDL abnormalities may be different from the one by traditional understanding. Therefore, it should he clarified by further research.

关 键 词：心力衰竭 肝功能 肾功能 血脂 

分 类 号：R541.4[医药卫生—心血管疾病]