心脏超声预判慢性左心疾病相关性肺动脉高压患者临床疗效及近期预后  

A study of ultrasonic diagnosis to predict the clinical efficacy and recent prognosis of pulmonary hypertension due to left heart disease

作　　者：张妙林[1] 章慧慧[1] 袁红[1] 孙金栋[1] Zhang Miaolin Zhang Huihui Yuan Hong Sun Jindong(Hangzhou Yuhang First Hospital, Hangzhou 311100, China)

机构地区：[1]杭州市余杭区第一人民医院心内科,311100

出　　处：《中国心血管杂志》2016年第5期384-387,共4页Chinese Journal of Cardiovascular Medicine

基　　金：浙江省中医药管理局基金项目(2014ZZ004);杭州市余杭区科技局项目(2015-005)~~

摘　　要：目的 本研究评判超声诊断左心疾病相关性肺动脉高压是否能够作为心衰的临床疗效及临床终点事件的独立预测指标。方法 入院心衰患者根据心脏超声测定肺动脉压力,分为两组：Ⅰ组（61例）：肺动脉收缩压50-70 mm Hg;Ⅱ组（49例）：肺动脉收缩压〉70 mm Hg。两组患者均进行优化抗心衰药物治疗,同时比较住院治疗前后各项临床指标,包括6 min步行距离、动脉血二氧化碳分压、左室射血分数、瓣膜反流情况、平均住院天数,并通过门诊与电话随访,比较1年内再入院人数及病死人数。结果 （1）两组患者治疗后左室射血分数分别为52%±8%、47%±7%,差异无统计学意义（P=0.43）;Ⅰ组患者6 min步行距离[（421±107）m比（379±118）m]、动脉血二氧化碳分压[（35±10）mm Hg比（42±16）mm Hg],优于Ⅱ组患者,差异均有统计学意义（均为P〈0.05）;两组患者住院平均天数Ⅱ组为（8.7±3.6）d,高于I组患者（10.3±3.9）d（P=0.04）。（2）两组患者治疗后1年内再入院人数、病死人数,Ⅰ组患者为21.3%、4.9%,Ⅱ组患者为42.9%、18.4%,Ⅰ组低于Ⅱ组,差异均有统计学意义（均为P〈0.05）。结论 超声诊断左心疾病相关性肺动脉高压对慢性心衰患者预后有独立的评判价值。Objective To study the ultrasonic diagnosis as independent predictor of prognosis of chronic heart failure patients with pulmonary hypertension due to left heart disease by clinical curative effect and clinical endpoint events.Methods Patients with chronic heart failure will be divided into two group according to pulmonary hypertension,Ⅰ group（n=61）pulmonary hypertension 50-70 mmHg,Ⅱgroup（n=49）pulmonary hypertension〉70 mmHg.Both two groups accept the treatment of heart failure,then compare the clinical curative effect and clinical endpoint events including 6 minutes walking test,PCO2 ,left ventricle ejection fraction, valves regurgitation, average hospitalization day and the readmission and mortality in a year.Results （1）Two groups had no statistical significance in the left ventricle ejection fraction,as the data were （52 ±8）%,（47 ±7）%（P=0.43）;two groups had statistical significance in 6 minutes walking test, PCO2 and hospitalization day,as the data were （421 ±107）m vs.（379 ±118）m,（35 ±10）mmHg vs.（42 ± 16）mmHg,（8.7 ±3.6）d vs.（10.3 ±3.9）d（all P＆lt;0.05）. ②Two groups also had statistical significance in readmission and mortality,as I group were 21.3%,4.9%;Ⅱgroup were 42.9%,18.4%. Conclusions The ultrasonic diagnosis of pulmonary hypertension due to left heart disease can be an independent predictor of prognosis of heart failure patients with pulmonary hypertension due to left heart disease.

关 键 词：心力衰竭 充血性 高血压 肺性 诊断 预后 

分 类 号：R544.1[医药卫生—心血管疾病]