不同射血分数心力衰竭患者临床特征的对比分析  

Contrastive Analysis on Clinical Features in Heart Failure Patients with Different Ejection Fractions

作　　者：何显菁[1] HE Xianjing(Beihai People's Hospital,Beihai 536000,China)

机构地区：[1]广西壮族自治区北海市人民医院

出　　处：《实用心脑肺血管病杂志》2019年第8期96-99,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的对比分析不同射血分数(EF)心力衰竭患者的临床特征。方法随机选取2012年7月—2019年2月北海市人民医院心血管内科收治的心力衰竭患者496例,根据EF分为射血分数保留的心力衰竭(HFpEF)组209例、射血分数中间值心力衰竭(HFmrEF)组118例及射血分数降低的心力衰竭(HFrEF)组169例。比较三组患者一般资料、实验室检查指标、超声心动图检查指标及心力衰竭病因。结果(1)三组患者体质指数(BMI)、糖尿病发生率、高脂血症发生率比较,差异无统计学意义(P>0.05)。HFmrEF组和HFrEF组患者年龄小于HFpEF组,女性比例及高血压发生率低于HFpEF组(P<0.05);HFrEF组患者肺炎及心房颤动发生率低于HFmrEF和HFpEF组(P<0.05)。(2)三组患者肌酐、同型半胱氨酸(Hcy)水平比较,差异无统计学意义(P>0.05)。HFmrEF组和HFrEF组患者氨基末端脑钠肽前体(NT-proBNP)水平高于HFpEF组,HFrEF组患者NT-proBNP水平高于HFmrEF组(P<0.05)。(3)三组患者左心房内径(LAD)、室间隔厚度(IVSD)比较,差异无统计学意义(P>0.05)。HFmrEF组和HFrEF组患者左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)大于HFpEF组,HFrEF组患者LVESD及LVEDD大于HFmrEF组(P<0.05);HFrEF组患者右心室内径(RVD)大于HFpEF组(P<0.05)。(4)三组患者心力衰竭病因比较,差异有统计学意义(P<0.01)。HFpEF组患者以老年退行性心脏瓣膜病最为常见,占49.3%;HFmrEF组和HFrEF组患者均以扩张型心肌病最为常见,分别占44.9%、71.0%。结论HFpEF好发于老年女性,并常合并高血压、肺炎、心房颤动,主要发病原因为老年退行性心脏瓣膜病;HFmrEF和HFrEF好发于中年男性,主要发病原因均为扩张型心肌病,但HFmrEF患者常合并肺炎及心房颤动,HFrEF患者NT-proBNP水平偏高。Objective To contrastively analyze the clinical features in heart failure patients with different ejection fractions.Methods From July 2012 to February 2019,a total of 496 patients with heart failure were selected in the Department of Cardiovascular Medicine,Beihai People's Hospital,and they were divided into HFpEF group(with ejection fraction preserved heart failure,n=209),HFmrEF group(with ejection fraction mid-range heart failure,n=118)and HFrEF group(with ejection fraction reduced heart failure,n=169)according to the ejection fraction.General information,laboratory examination results,echocardiography examination results and causes of heart failure were compared in the three groups.Results(1)There was no statistically significant difference in BMI,incidence of diabetes or hyperlipidemia in the three groups(P>0.05).Age,female ratio and incidence of hypertension in groups HFmrEF and HFrEF were statistically significantly lower than those in HFpEF group(P<0.05);incidence of pneumonia and atrial fibrillation in HFrEF group was statistically significantly lower than that in groups HFmrEF and HFpEF,respectively(P<0.05).(2)There was no statistically significant difference in Cr or Hcy in the three groups(P>0.05);NT-proBNP in groups HFmrEF and HFrEF was statistically significantly higher than that in HFpEF group,respectively,meanwhile NT-proBNP in HFrEF group was statistically significantly higher than that in HFmrEF group(P<0.05).(3)There was no statistically significant difference in LAD or IVSD in the three groups(P>0.05).LVESD and LVEDD in groups HFmrEF and HFrEF were statistically significantly greater than those in HFpEF group,meanwhile LVESD and LVEDD in HFrEF group were statistically significantly greater than those in HFmrEF group(P<0.05);RVD in HFrEF group was statistically significantly greater than that in HFpEF group(P<0.05).(4)There was statistically significant difference in causes of heart failure in the three groups(P<0.01).Degenerative heart valvular disease was the most common cause(accounting for

关 键 词：心力衰竭 疾病特征 射血分数保留的心力衰竭 射血分数中间值心力衰竭 射血分数降低的心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]