心力衰竭的物理诊断现状  

The Current Situation of Physical Diagnosis of Heart Failure

作　　者：高振[1] 梁兆光[1] 姚虹[1] 潘文静[1] 龚春琳[1] 田艳丰[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2017年第4期777-779,687,共4页Progress in Modern Biomedicine

摘　　要：心力衰竭是各种心脏疾病发展的终末阶段,及时准确的确诊心力衰竭、辨别其病情变化可进一步指导治疗及缩短住院时间,并为心力衰竭的预后评价提供参考依据。目前,确诊心力衰竭主要基于患者的临床症状、体征及各种影像学表现、生化指标等做出综合评价,而物理诊断是诊断心力衰竭不可或缺的依据。心脏彩超已应用于临床多年,可从多个层面评估左室充盈压,是初步评价心脏功能的便捷措施。核心脏病学可评估心脏交感神经支配的区域及激活模式,预测心力衰竭的发病率和死亡率。心脏磁共振可用于进行危险分层及确定是否适合手术/介入治疗。此外,心脏CT及心导管术也是用于评价心功能的常见物理检查方法。本文主要总结了目前各种诊断心力衰竭的物理诊断方法的最新进展,以进一步指导临床实践。Heart failure was the end stage of the development of various heart diseases, Timely and accurate diagnosis and identification of the changes of patients＇ condition could further guide the treatment, shorten the hospital stay and provide references for the prognostic evaluation of heart failure. Currently, the diagnosis of heart failure was mainly based on many methods to make a comprehensive evaluation including clinical symptoms, signs, and various imaging, biochemical indicators. The physical diagnosis was the indispensable basis for the diagnosis of heart failure. Echocardiography had been used in clinical applications for many years, which could assess the left ventricular filling pressure from several levels, and become a convenient measure to evaluate the preliminarily cardiac function. Nuclear cardiology could assess the cardiac sympathetic innervations regional and active mode which could predict the morbidity and mortality of heart failure. The role of cardiac magnetic resonance imaging in heart failure had been recognized, and could be used to establish the risk stratification and the suitability of surgical/interventional treatment. In addition, cardiac CT and cardiac catheterization were also used to assess the cardiac function. This article summarized the current situation of physical diagnosis of heart failure to further guide clinical practice.

关 键 词：心力衰竭 物理诊断 心脏磁共振 心脏彩超 心导管术 

分 类 号：R541.61[医药卫生—心血管疾病]