心力衰竭超声心动图参数与中医辨证分型的关系  

Relationship Between Echocardiographic Parameters of Heart Failure and TCM Syndrome Differentiation

作　　者：党欢[1] 李碧晶 刘晗 DANG Huan;LI Bi-jing;LIU Han(Guangdong Provincial Hospital of Chinese Medicine,Guangdong Guangzhou 510000)

机构地区：[1]广东省中医院,广东广州510000

出　　处：《深圳中西医结合杂志》2022年第8期57-61,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省中医药局科研项目(20192029)。

摘　　要：目的:探讨左室射血分数保留心力衰竭(HFpEF)和左室射血分数减少心力衰竭(HFrEF)超声心动图相关参数与心力衰竭(HF)中医辨证分型的关系。方法:收集2019年1月至2021年12月广东省中医院大学城医院心血管科门诊及住院部收治的HF患者共115例,根据左室射血分数(LVEF)正常或≥45%将患者分为HFpEF组(LVEF≥45%)55例和HFrEF组(LVEF<45%)60例。按照HF中医辨证分型分为心肾阳虚证、气虚血瘀证、阳虚水泛证。采用超声心动图彩色多普勒超声诊断仪测量患者的左室整体纵向应变(LVGLS)、左室舒张末容积指数(LVEDVI)、左室收缩末容积指数(LVESVI)、组织多普勒二尖瓣舒张早期运动速度(e')和舒张早期二尖瓣口血流速度与二尖瓣环速度比(E/e'),观察不同辨证分型与超声心动图相关参数的关系。结果:所有HF患者中,心肾阳虚证、气虚血瘀证、阳虚水泛证的LVEDVI、E/e'依次升高,e'依次下降;HFpEF患者中,心肾阳虚证、气虚血瘀证、阳虚水泛证的LVGLS依次下降;HFrEF患者中,心肾阳虚证、气虚血瘀证、阳虚水泛证的LVEDVI、LVESVI和E/e'依次升高,e'依次下降,差异均具有统计学意义(P<0.05);HFpEF组心肾阳虚证患者的LVGLS明显高于HFrEF组,差异具有统计学意义(P<0.05);HFpEF组气虚血瘀证患者的LVGLS和e'明显高于HFrEF组,LVEDVI和LVESVI明显低于HFrEF组,差异均具有统计学意义(P<0.05);HFpEF组阳虚水泛证患者的LVGLS明显高于HFrEF组,LVEDVI和LVESVI明显低于HFrEF组,差异均具有统计学意义(P<0.05)。结论:HFpEF、HFrEF的中医辨证分型与超声心动图不同参数之间具有一定差异性及规律性,两者之间存在量化的关系。超声心动图参数可反映HF病情进展,对其中医辩证分型有指导意义。Objective To investigate the relationship between echocardiographic parameters of heart failure with preserved left ventricular ejection fraction(HFpEF)and heart failure with reduced left ventricular ejection fraction(HFrEF)with traditional Chinese medicine(TCM)syndrome differentiation of heart failure(HF).Methods A total of 115 HF patients admitted to the outpatient and inpatient departments of cardiovascular Department in University Town Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2019 to December 2021 were collected.Patients were divided into HFpEF group with 55 cases and HFrEF group with 60 cases according to normal or≥45%left ventricular ejection fraction(LVEF).According to TCM syndrome differentiation of HF,it can be divided into heart-kidney Yang deficiency syndrome,Qi deficiency and blood stasis syndrome,Yang deficiency and water flooding syndrome.Using echocardiography color doppler ultrasonic diagnostic instrument measurement in patients with left ventricular longitudinal strain(LVGLS),left ventricular end-diastolic volume index(LVEDVI),left ventricular contraction at the end of the volume index(LVESVI)and tissue doppler mitral valve early diastolic velocity(e')and early diastolic mitral valve orifice blood flow velocity and mitral annulus velocity ratio(E/e'),to observe the relationship between different syndrome differentiation types and echocardiographic parameters.Results In all HF patients,the LVEDVI and E/e'of heart-kidney Yang deficiency syndrome,Qi deficiency blood stasis syndrome and Yang-deficiency water-flooding syndrome increased and E'decreased successively.In HFpEF patients,LVGLS of heart and kidney Yang deficiency syndrome,Qi deficiency and blood stasis syndrome,Yang deficiency and water syndrome decreased successively.In HFrEF patients,the LVEDVI,LVESVI and E/e'of heart-kidney Yang deficiency syndrome,Qi deficiency blood stasis syndrome and Yang deficiency water flooding syndrome were increased and E'was decreased successively,with statistical

关 键 词：左室射血分数保留心力衰竭 左室射血分数减少心力衰竭 中医辨证分型 超声心动图 

分 类 号：R256.2[医药卫生—中医内科学]