慢性心力衰竭患者心肌能量代谢变化及其与左心室重构的关系分析  

Changes of myocardial energy metabolism and its relationship with left ventricular remodeling in patients with chronic heart failure

作　　者：樊丹 罗伟[1] FAN Dan;LUO Wei(Department of Traditional Chinese Medicine,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院中医科,221000

出　　处：《浙江医学》2022年第21期2313-2316,共4页Zhejiang Medical Journal

基　　金：徐州市科技计划项目(XZZD1236)。

摘　　要：目的探讨慢性心力衰竭患者心肌能量代谢变化及其与左心室重构的关系。方法选择徐州市中心医院2019年6月至2021年9月收治的慢性心力衰竭患者118例作为观察组,另择同期在本院体检的健康人群120名作为对照组。检测两组对象的心肌能量代谢变化指标[左心室收缩末期圆周室壁应力(cESS)、心肌能量消耗(MEE)、血清游离脂肪酸(FFA)]和左心室重构指标[左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室射血分数(LVEF)、左心室质量指数(LVMI)],并分析两者的相关性。结果观察组cESS、MEE、血清FFA水平均高于对照组(均P<0.05);观察组LVEDd、LVESd、LVMI均高于对照组(均P<0.01),而LVEF低于对照组(P<0.01)。观察组cESS、MEE、血清FFA水平与LVEDd、LVESd、LVMI均呈正相关(均P<0.05),与LVEF均呈负相关(均P<0.05)。结论慢性心力衰竭患者心肌能量代谢变化与左心室重构密切相关,两指标可互相评估指导临床个体化治疗。Objective To investigate the changes of myocardial energy metabolism and its relationship with left ventricular remodeling in patients with chronic heart failure(CHF).Methods One hundred and eighteen patients with CHF treated in Xuzhou Central Hospital from June 2019 to September 2021 and 120 healthy subjects undertaking physical check up(control group)were recruited in the study.The myocardial energy metabolism indexes,including left ventricular end systolic circumferential wall stress(cESS),myocardial energy expenditure(MEE)and serum free fatty acid(FFA),and left ventricular remodeling indexes,including left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),left ventricular ejection fraction(LVEF)and left ventricular mass index(LVMI)were measured in the two groups,and their correlations were analyzed.Results The levels of cESS,MEE,serum FFA in the CHF group were higher than those in the control group(all P<0.05).The levels of LVEDd,LVESd and LVMI in the CHF group were higher than those in the control group(all P<0.01),while the level of LVEF was lower than that of control group(P<0.01).The levels of cESS,MEE,serum FFA were positively correlated with LVEDd,LVESd and LVMI(all P<0.05),and negatively correlated with LVEF(all P<0.05).Conclusion The changes of myocardial energy metabolism in patients with CHF are closely related to left ventricular remodeling,which can be used to guide individualized treatment of CHF patients.

关 键 词：心力衰竭 心肌 能量代谢 左心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]