人类免疫缺陷病毒感染者心脏收缩与舒张功能变化特点  

The characteristics of cardiac systolic and diastolic function changes in human immunodeficiency virus-infected patients

作　　者：罗玲[1] 李雁翎[1] 李玲[2] 叶益聪[2] 邱志峰[1] 韩扬[1] 曾勇[2] 李太生[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院感染内科,100730 [2]中国医学科学院中国协和医科大学北京协和医院心内科,100730

出　　处：《中华传染病杂志》2017年第6期348-351,共4页Chinese Journal of Infectious Diseases

摘　　要：目的探讨无心血管疾病的HIV感染者心脏收缩及舒张功能改变。方法选择北京协和医院感染内科长期随诊的HIV感染者42例，均接受12个月以上的HAART，且病毒被抑制、无心脏疾病表现。另选30名年龄、性别相匹配、无心血管疾病表现的健康者作为对照。通过心脏彩色多普勒超声检查，比较HIV感染者和健康对照者的心脏收缩功能及舒张功能指标。结果心脏舒张功能异常患者HIV感染组20例，健康对照组6例，差异有统计学意义（χ2＝5.79，P＝0.007）。心脏舒张功能指标中，HIV感染者E峰减速时间为（161.87±21.64） ms，健康对照者为（190.34±37.22） ms，差异有统计学意义（t＝－3.20，P＝0.002）。HIV感染者的早期舒张峰最大血流速度/晚期舒张峰血流速度（E/A）比值为1.16±0.35、早期舒张峰最大运动速度（Ea）为（10.18±2.80） cm/s、E/Ea比值为5.43±1.99、左室等容舒张时间为（93.18±20.34） ms；健康对照者E/A比值为1.19±0.26、Ea为（11.45±2.75） cm/s、E/Ea比值为5.78±0.91、左室等容舒张时间为（93.57±18.55） ms，差异均无统计学意义（t值分别为1.13、0.29、1.53和0.67，均P〉0.05）。心脏收缩功能指标中，HIV感染者射血分数为（66.7±6.4）%、左室缩短率为（37.08±4.79）%，健康对照者分别为（68.7±4.2）%、（38.17±3.96）%，差异无统计学意义（t值分别为－1.51、－1.00，均P〉0.05）。结论HIV感染者亚临床的心脏舒张功能异常发生率显著高于健康对照者，而心脏收缩功能无明显差异。ObjectiveTo understand the changes of cardiac systolic and diastolic function in human immunodeficiency virus （HIV）-infected patients without evidence of cardiac disease in China. MethodsForty-two HIV-infected patients who were followed up in the Department of Infectious Diseases at Peking Union Medical College Hospital without cardiac involvement were recruited. All the HIV-infected patients had received highly active antiroviral therapy （HAART） for more than 12 months with viral suppression. And 30 age and sex matched healthy subjects without cardiac disease manifestations were enrolled as controls. Every group members underwent transthoracic echocardiography evaluation. The indexes of cardiac systolic and diastolic function between HIV-infected patients and healthy controls were compared.ResultsDiastolic abnormality occurred in 20 cases in HIV-infected group and 6 cases in control group, with statistically significant difference （χ2=5.79, P=0.007）. The E wave deceleration time （EDT） in HIV-infected patients were significantly decreased than healthy controls （[161.87±21.64] ms vs. [190.34±37.22], t=-3.20, P=0.002）. There were no significant differences of E/A ratio （[1.16±0.35] vs. [1.19±0.26]）, E/Ea ratio （[5.43±1.99] vs. [5.78±0.91]）, isovolumic relaxation time （IVRT）, （[93.18±20.34] ms vs. [93.57±18.55]ms）, Ea （[10.18±2.80] cm/s vs. [11.45±2.75] cm/s） between HIV-infected patients and controls （t=1.13, 1.53, 0.67 and 0.29, respectively, all P〉0.05）. Among cardiac systolic function markers, left ventricular ejection fractions in HIV-infected patients and control group were （66.7±6.4）% and （68.7±4.2）%, respectively. And left ventricular shortening rates were （37.08±4.79）% and （38.17±3.96）%, respectively. Both showed no significant difference between the two groups （t=-1.51 and -1.00, respectively, both P〉0.05）.ConclusionsCompared with control group, subclinical cardiac diastolic dysfunction is more frequently observed in HIV-in

关 键 词：人类免疫缺陷病毒 心脏功能 超声心动描记术 多普勒 彩色 

分 类 号：R512.91[医药卫生—内科学]