慢性心力衰竭患者心功能恢复的相关因素研究  

Factors influencing cardiac function recovery in patients with chronic heart failure

作　　者：任妍[1] 张凤如[1] 吴方[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,200025

出　　处：《国际心血管病杂志》2016年第6期379-382,共4页International Journal of Cardiovascular Disease

摘　　要：目的：分析影响慢性心力衰竭（CHF）患者心功能恢复的相关因素。方法：连续入选232例诊断为CHF并至少随访1年的患者,记录患者临床和生化资料,并定期行超声心动图检测。Logistic回归分析评估影响CHF患者心功能恢复的相关因素。结果：232例患者中56例患者心功能恢复,176例患者心功能未恢复。扩张型心肌病患者较缺血性心肌病患者心功能更易恢复（P〈0.05）,围生期心肌病患者预后良好。与体质量正常或过轻患者相比,体质量指数（BMI）较高的CHF患者心功能更易恢复（P〈0.05）。心功能恢复患者基础心率偏快,β受体阻滞剂耐受剂量较大,药物治疗后心率下降较明显（P均〈0.001）。Logistic回归分析显示,患者心功能恢复与CHF病因（OR=1.322,95%CI：1.256~1.392,P=0.04）和β受体阻滞剂剂量（OR=2.483,95%CI：2.359~2.614,P〈0.001）相关。结论：CHF病因和β受体阻滞剂剂量与CHF患者心功能恢复相关,BMI及基础心率较高患者心功能易于恢复。Objective：To explore the related factors influencing cardiac function recovery in patients with chronic heart failure（CHF）. Methods：A total of 232 consecutive patients with CHF who had follow-up of at least 1 year were included.Clinical features and biochemical measurements were recorded,and echocardiography was performed for regular intervals.Logistic regression analysis was used to determine the factors influencing cardiac function recovery. Results：Among overall 232 patients with CHF,56 had cardiac function recovery and 176 did not have.Patients with dilated cardiomyopathy were more likely to have cardiac function recovery than patients with ischemic cardiomyopathy（P〈0.05）.Patients with peripartum cardiomyopathy usually experienced a favorable outcome.Compared with the patients with normal or too light boby mass index（BMI）,cardiac function of the patients with higher BMI was more easy to recover（P〈0.05）.The patients who cardiac function recovered had faster basal heart rates and higherβblockers tolerance doses,and their heart rates decreased significantly after drug treatment（all P〈0.001）.Logistic regression analysis revealed that etiology of CHF（OR=1.322,95%CI：1.256~1.392,P=0.04）and doses ofβblockers（OR=2.483,95%CI：2.359~2.614,P〈0.001）were independent factors associated with cardiac function recovery in patients with CHF.Conclusions：In patients with CHF,cardiac function recovery is related to etiology of CHF and dose ofβblocker.Patients with higher BMI and basal heart rates are more likely to get cardiac function recovery.

关 键 词：慢性心力衰竭 左心室射血分数 心功能恢复 预后 

分 类 号：R541.6[医药卫生—心血管疾病]