左室舒张功能不全分级与临床H2FPEF评分诊断HFpEF的比较研究  

Comparison of Classification of Diastolic Function and H2FPEF Score in Diagnosis of Heart Failure with Preserved Ejection Fraction

作　　者：刘秋颖 张云山 王璐璐 Liu Qiuying;Zhang Yunshan;Wang Lulu(Department of Ultrasound,The Sixth Medical Centre of PLA General Hospital,Beijing 100048,China;The Medical District South of Beijing,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心超声科,北京市100048 [2]京南医疗区,北京市100048

出　　处：《中国超声医学杂志》2022年第5期529-532,共4页Chinese Journal of Ultrasound in Medicine

基　　金：解放军总医院第六医学中心创新培育基金(No.CXPY201924)。

摘　　要：目的探讨超声左室舒张功能不全(LVDD)分级和临床H;FPEF评分在诊断射血分数保留型心力衰竭(HFpEF)的应用价值。方法将164例呼吸困难患者进行超声LVDD分级,采用6个临床变量进行H;FPEF评分并分为低分、中分、高分3组,然后对照临床诊断结果进行统计学分析。结果164例患者中99例临床诊断为HFpEF,包括LVDDⅢ级11例、Ⅱ级68例和Ⅰ级16例,包括H;FPEF评分高分16例、中分67例和低分16例;不同H;FPEF评分组间左房容积指数、三尖瓣反流速度、二尖瓣舒张早期流速与二尖瓣环舒张早期运动速度比值(E/e′)有统计学意义且随评分增高呈升高趋势;LVDD分级、H;FPEF评分及二者联合诊断HFpEF的ROC曲线下面积分别为0.740、0.818和0.884;Logistic回归分析显示LVDD分级和H;FPEF评分的Exp(B)值分别为14.153和1.888。结论超声LVDD分级和临床H;FPEF评分对HFpEF均具有重要诊断价值,二者联合可提高诊断效能。Objective To study the clinic value of classification of left ventricle diastolic dysfunction(LVDD)and H;FPEF score in diagnosis of heart failure with preserved ejection fraction(HFpEF).Methods 164 patients with dyspnea were classificated according to LVDD by echocardiography and calculated H;FPEF score according to 6 clinical variables.Results 99 patients were diagnosed as HFpEF in all patients.There were 11 cases with LVDD gradeⅢ,68 cases with gradeⅡ,16 cases with grade I in those definite cases.There were 16 cases with high H;FPEF score,67 cases with moderate H;FPEF score and 16 cases with low H;FPEF score in those 99 patients.There was significant difference in left atrial volume index,velocity of tricuspid valve regurgitation,ratio of early mitral inflow velocity to early diastolic mitral annular velocity between 3 H;FPEF score groups.The area under ROC curve of classification of LVDD,H;FPEF score and combination were 0.740,0.818 and 0.884.Logistic regression analysis showed the Exp(B)of classification of LVDD and H;FPEF score were 14.153 and 1.888.Conclusions Classification of LVDD and H;FPEF score were valuable to diagnosis of HFpEF.Combination of them has more diagnostic efficiency.

关 键 词：超声心动图 分级 舒张 H FPEF评分 射血分数保留型心力衰竭 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.6[医药卫生—诊断学]