心电心音图参数与慢性心力衰竭患者脑利钠肽、左室射血分数及心功能分级的相关性  

Correlation between the parameters of acoustic cardiography and BNP, LVEF and cardiac function grading in patients with chronic heart failure

作　　者：谢倩[1] 张福伟[1] 陈漠水[1] 张忆雪 任良强[1] 邢波[1] 李大严[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院心血管内科,海口570208

出　　处：《中华医学杂志》2018年第1期25-29,共5页National Medical Journal of China

基　　金：海南省海口市重点科技计划项目（2014-068）

摘　　要：目的探究新一代心音图技术在心力衰竭诊断中的相关参数与脑利钠肽（BNP）、左室射血分数（LVEF）及心功能分级的相关性。方法选取海口市人民医院心内科2016年5月至2017年7月期间住院病人168例为心功能不全组（心功能I级组29例，心功能Ⅱ级40例，心功能Ⅲ级64例，心功能Ⅳ级35组），选取体检心功能正常者87例为健康组，分别行心音图检查、BNP测定、LVEF检查，进行数据分析。结果QRS间期、EMAT％、EMAT、SDI、s3等指标在心功能不同分级中组间差异具有统计学意义（P〈0．05）；LVST在心功能I级与正常组中差异无统计学意义（P〉0．05），其他分组间差异具有统计学意义；QRS间期、EMAT％、SDI、s3与BNP之间存在正相关性（t值分别为9．46、11．38、12．14、9．67，P〈0．05），LVST与BNP存在负相关性（t值-14．27，P〈0．05）；QRS间期、EMAT％、SDI、s3与LVEF之间存在负相关性（t值分别为11．24、-8．764、-2．393、-0．579，P〈0．05），LVST与LVEF之间存在正相关性（t值23．48，P〈0．05）；QRS间期、EMAT％、SDI、s3与心功能分级之间存在正相关性（B分别为0．003、0．234、0．419、0．352，P〈0．05），LVsT与心功能分级存在负相关性（β-0．021，P〈0．05）。结论心音图参数EMAT％、EMAT、SDI、s3与BNP、LVEF、心功能分级存在密切相关性，可作为心力衰竭患者诊断和评估的辅助指标。Objective To explore the correlation between the parameters of the new generation of Acoustic Cardiography and brain natriuretic peptide （BNP） , left ventricular ejection fraction （LVEF） and cardiac function grading in the diagnosis of heart failure. Methods One hundred and sixty-eight inpatients, who were hospitalized in Department of Cardiology, Haikou People＇s Hospital from May 2016 to July 2017, were enrolled as heart failure group, including NYHA class I （n = 29）, NYHA class 11 （ n = 40）, NYHA class Ill （n = 64） , NYHA class 1V （n = 35 ）. And eighty-seven patients with normal cardiac function were selected as healthy control group. The data of the two groups were analyzed after the Acoustic Cardiography test, BNP determination and LVEF examination. Results The differences in QRS duration, electromechanical activation time （EMAT） , EMAT% , systolic dysfunction index （SDI）, third heart sound （$3） and other indicators among the groups with different levels of cardiac function were statistically significant （P 〈 0.05 ）. The difference in left ventricular systolic time （LVST） between the cardiac function grade I and healthy group was not significant （ P 〉 0.05 ） , while the differences among the rest groups were significant. There was a positive correlation between QRS duration, EMAT% , SDI, $3 and BNP （ t = 9.46, 11.38, 12.14, 9.67, respectively, P 〈 0.05） ; LVST and BNP were negatively correlated （t = - 14.27, P 〈 0.05 ）. There was a negative correlation between QRS duration, EMAT% , SDI, $3 and LVEF （ t = 11.24, - 8. 764, - 2. 393, - 0. 579, respectively, P 〈 0.05 ）. There was a positive correlation between LVST and LVEF （ t = 23.48, P 〈 0.05 ）. There was a positive correlation between QRS duration, EMAT%, SDI, $3 and cardiac function grading （ 13 = 0. 003, 0. 234, 0.419, 0. 352, respectively, P 〈 0.05 ）. There was a negative correlation between LVST and cardiac function grade （ 13 = - O. 021, P 〈 0.05 ）. Conclusion The p

关 键 词：心力衰竭 心功能分级 心电心音图 左心室射血分数 脑利钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]