血清三碘甲状腺原氨酸与左心室舒张末期压力水平对收缩功能保留的心力衰竭患者心脏舒张功能的预测价值  

The predictive value of serum triiodothyronine and left ventricular end diastolic pressure levels on diastolic function in patients with heart failure with preserved ejection fraction

作　　者：肖洒 胡艳丽[1] 翟莉[1] Xiao Sa;Hu Yanli;Zhai Li(The Second Department of Internal Medicine,Beijing General Hospital of the People’s Armed Police Force of China,Beijing 100027,China)

机构地区：[1]中国人民武装警察部队北京市总队医院内二科,北京100027

出　　处：《心脑血管病防治》2021年第3期222-224,229,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的分析收缩功能保留的心力衰竭(HFpEF)患者血清三碘甲状腺原氨酸(T3)与左心室舒张末期压力(LVEDP)水平对心脏舒张功能的预测价值。方法回顾性分析2014年1月至2018年1月武装警察部队北京总队医院82例HFpEF患者的临床资料,经左心室导管测定LVEDP的水平以评估心脏舒张功能。依据所测T3的均值(4.35 pmol/L),分为A组(T3<4.35pmol/L)37例和B组(T3≥4.35 pmol/L)45例。比较两组临床基线资料,采用Pearson相关性分析T3与LVEDP的关系,记录患者24个月内主要终点事件,采用多因素Logistic回归分析影响患者预后情况的危险因素。结果A组平均年龄大于B组,伴有糖尿病史的比例高于B组,美国纽约心脏病学会(NYHA)分级Ⅲ~Ⅳ级患者多于B组,LVEDP值和E峰值均高于B组,E峰减速时间明显短于B组(t/χ^(2)=3.852、6.306、9.128、3.894、3.774、2.769,均P<0.05)。经Pearson相关性分析显示,HFpEF患者血清T3水平与LVEDP值存在线性负相关(r=-0.594,P<0.05)。随访24个月,A组再住院率和死亡率均明显高于B组(χ^(2)=5.499、4.673,均P<0.05)。结论HFpEF患者血清T3水平较低者心脏舒张功能可能较差,提示预后不良的风险性较高。Objective To analyze the predictive value of serum triiodothyronine(T3)and left ventricular end diastolic pressure(LVEDP)on diastolic function in patients with heart failure with preserved ejection fraction(HFpEF).Methods The clinical data of 82 patients with HFpEF from January 2014 to January 2018 in Beijing General Hospital of the People’s Armed Police Force were analyzed retrospectively.The level of LVEDP was measured by left ventricular catheter to evaluate the diastolic function.According to the mean value of T3(4.35 pmol/L),patients were divided into group A(T3<4.35 pmol/L)including 37 cases and group B(T3≥4.35 pmol/L)including 45 cases.Clinical baseline data of the two groups were compared.The relationship between T3 and LVEDP was analyzed by Pearson correlation.The main end point events were recorded within 24 months.The risk factors influencing the prognosis of patients were analyzed by multivariate logistic regression.Results The average age of group A was older than that of group B,the proportion of patients with diabetes history was higher than that of group B,the proportion of New York Heart Association(NYHA)classificationⅢ~Ⅳwas higher than that of group B,the LVEDP value and E peak value were higher than those of group B,and the deceleration time of E peak was shorter than that of group B(t/χ^(2)=3.852,6.306,9.128,3.894,3.774,2.769;all P<0.05).Pearson correlation analysis showed that there was a linear negative correlation between serum T3 and LVEDP in HFpEF patients(r=-0.594,P<0.05).After 24 months follow-up,therates of readmission and mortality in group A were significantly higher than those in group B(χ2=5.499,4.673;both P<0.05).Conclusion The diastolic function may be poor in HFp EF patients with low serum T3 level,suggesting a higher risk of poor prognosis.

关 键 词：射血分数保留的心力衰竭 三碘甲状腺原氨酸 左心室舒张末期压力 心脏功能 

分 类 号：R541.6[医药卫生—心血管疾病]