射血分数正常的老年病人衰弱与左室舒张功能相关性研究  

Correlation between frailty and left ventricular diastolic function in the elderly patients with nor-mal ejection fraction

作　　者：杨婧[1] 习玲[1] 许建萍[2] 郝春艳[1] 祁琨[1] 王荣荣[1] 张轶伟[1] YANG Jing;XI Ling;HAO Chun-yan;QI Kun;WANG Rong-rong;ZHANG Yi-wei;XU Jian-ping(Department of Geriatrics,the First Hospital of Shanxi Medical University,Taiyuan 030000,China;Department of Ultrasonic Imaging,the First Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一医院老年病科,山西省太原市030000 [2]山西医科大学第一医院超声影像科,山西省太原市030000

出　　处：《实用老年医学》2020年第3期291-294,298,共5页Practical Geriatrics

摘　　要：目的探讨LVEF正常(≥50%)的老年病人衰弱程度与左室舒张功能的相关性。方法收集2018年2~11月我院住院老年(≥60岁)病人100例,应用Fried衰弱量表对入选病人进行衰弱评估,分为无衰弱组(n=25)、衰弱前期组(n=50)和衰弱组(n=25)。测定所有病人的常规心功能参数:LVEF、左室舒张末期内径(LVDD)、左室收缩末期内径(LVSD)、左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、短轴缩短率(FS)、二尖瓣E峰血流速度(E)、二尖瓣A峰血流速度(A)、二尖瓣环间隔侧和侧壁侧平均组织多普勒速度(e'),并计算E/A、E/e';检测并比较3组白蛋白、TC、TG、HDL-C、LDL-C、Hcy、N末端B型利钠肽原(NT-proBNP)水平,并分析衰弱程度与上述指标的相关性。结果3组年龄、NT-proBNP水平和TC水平比较,差异有统计学意义(P<0.05或P<0.01)。3组间LVEF、LVDD、LVSD、EDV、ESV、FS差异无统计学意义(P>0.05)。将年龄进行分层,分析衰弱与左室舒张功能的关系显示:在年龄<80岁的病人中,随衰弱程度增加,E/e'增加,差异有统计学意义(P<0.05);在年龄≥80岁的病人中,随衰弱程度增加,e'减低,E/e'增加,差异均有统计学意义(P<0.05)。结论衰弱程度与左室舒张功能障碍严重程度相关;衰弱可能为射血分数保留的心力衰竭发生的危险因素之一。Objective To investigate the correlation between the degree of frailty and left ventricular diastolic function in the elderly patients with normal ejection fraction[left ventricular ejection fraction(LVEF)≥50%].Methods A total of 100 hospitalized geriatric patients aged over 60 years were enrolled from February to November 2018 in our hospital.The Fried scale was used to assess the degree of frailty,and the patients were divided into no frailty group(n=25),pre-frailty group(n=50)and frailty group(n=25).The conventional cardiac function parameters of all patients were measured.The levels of LVEF,left ventricular end-diastolic diameter(LVDD),left ventricular end-systolic diameter(LVSD),left ventricular end-diastolic volume(EDV),left ventricular end-systolic volume(ESV),fractional shortening(FS),mitral E peak flow velocity(E),mitral A peak blood flow velocity(A),average velocities of the septal and lateral sides of the mitral annulus(e')were detected,and E/A,E/e'were calculated.The levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),homocysteine(Hcy)and N-terminal-pro-brain natriuretic peptide(NT-proBNP)were detected and compared;The correlation between the degree of frailty and the above related indexes were analyzed.Results Age and the levels of NT-proBNP and TC were significantly different between the three groups(P<0.05 or P<0.01).There was no significant difference in LVEF,LVDD,LVSD,EDV,ESV and FS between the three groups(P>0.05).With the degree of frailty increased,E/e'value increased significantly in the patients younger than 80 years old(P<0.05);In the patients aged 80 years and older,as the degree of frailty increased,e'value decreased,and E/e'value increased significantly(P<0.05).Conclusions The degree of frailty is related to the severity of preclinical diastolic dysfunction.Frailty may be one of the risk factors for heart failure with preserved ejection fraction.

关 键 词：射血分数 衰弱 左室舒张功能障碍 

分 类 号：R331.31[医药卫生—人体生理学]