HFpEF患者ECHO检查特征及血清学相关指标变化与其NYHA分级的关系  

Correlation of ECHO characteristics and serological indexes changes with NYHA classification in HFpEF patients

作　　者：贺骞 黄婷 HE Qian;HUANG Ting(Second Department of Cardiology,Shangrao People's Hospital,Shangrao 334000,China)

机构地区：[1]上饶市人民医院心内二科,334000 [2]上饶市人民医院超声医学科,334000

出　　处：《中国现代药物应用》2024年第1期41-44,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨射血分数保留的心力衰竭(HFpEF)患者超声心动图(ECHO)检查特征及血清学相关指标变化与其美国纽约心脏病学会(NYHA)分级的关系。方法 选取120例HFpEF患者作为HFpEF组,依据NYHA分级将HFpEF组患者分为Ⅱ级组(42例)、Ⅲ级组(43例)、Ⅳ级组(35例);另选取同期121例健康体检的人员作为非心力衰竭组。检测并比较HFpEF组和非心力衰竭组ECHO指标[左室后壁厚度(LVPW)、室间隔厚度(IVS)、左心房内径(LAD)、左房容积指数(LAVI)、三尖瓣反流速度(TRV)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室射血分数(LVEF)、二尖瓣舒张早期最大血流速度/舒张晚期最大血流速度(E/A)]及血清血尿酸(BUA)、N末端脑钠肽前体(NT-proBNP)水平,比较HFpEF组不同NYHA分级患者血清BUA、NT-proBNP水平,分析HFpEF患者血清BUA、NT-proBNP水平与NYHA分级的相关性。结果 HFpEF组的LAD、LVDd、LVDs、E/A、LAVI、TRV分别为(45.37±5.95)mm、(49.75±5.72)mm、(33.72±3.84)mm、(0.74±0.11)、(45.52±5.53)ml/m^(2)、(2.94±0.31)m/s,均高于非心力衰竭组的(32.82±4.85)mm、(41.51±5.28)mm、(26.16±3.43)mm、(0.52±0.09)、(20.64±3.41)ml/m^(2)、(2.18±0.35)m/s,LVEF(61.24±7.86)%低于非心力衰竭组的(68.23±7.98)%,差异有统计学意义(P<0.05);两组IVS、LVPW比较,差异无统计学意义(P>0.05)。HFpEF组血清BUA、NT-proBNP分别为(486.88±68.91)μmol/L、(874.07±112.71)pg/ml,均高于非心力衰竭组的(287.87±35.82)μmol/L、(121.57±16.26)pg/ml,差异有统计学意义(P<0.05)。Ⅱ级组血清BUA、NT-proBNP分别为(345.67±47.82)μmol/L、(613.63±72.45)pg/ml,Ⅲ级组血清BUA、NT-proBNP分别为(512.14±63.59)μmol/L、(863.46±94.84)pg/ml,Ⅳ级组血清BUA、NT-proBNP分别为(625.31±72.42)μmol/L、(1199.62±137.51)pg/ml。HFpEF组不同NYHA分级患者血清BUA、NT-proBNP水平比较差异有统计学意义(P<0.05);Ⅲ级组、Ⅳ级组患者血清BUA、NT-proBNP水平均高于Ⅱ级组,且Ⅳ级组高于�Objective To discuss the correlation of echocardiogram(ECHO)characteristics and serological indexes changes with New York Heart Association(NYHA)classification in heart failure with preserved ejection fraction(HFpEF)patients.Methods A total of 120 HFpEF patients were selected as HFpEF group.According to NYHA classification,the patients in HFpEF group were divided into classⅡgroup(42 cases),classⅢgroup(43 cases),and classⅣgroup(35 cases).In addition,121 healthy subjects in the same period were selected as the non-heart failure group.ECHO parameters[left ventricular posterior wall thickness(LVPW),in-terventricular septum thickness(IVS),left atrial diameter(LAD),left atrial volume index(LAVI),tricuspid regurgitant velocity(TRV),left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVsD)and left ventricular ejection fraction(LVEF)],ratio of mitral early flow velocity to mitral late flow velocity(E/A)],blood uric acid(BUA)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels were detected and compared between HFpEF group and non-heart failure group.Serum BUA and NT-proBNP levels of patients with different NYHA classification in HFpEF group were compared.The correlation of serum BUA,NT-proBNP levels with NYHA classification in HFpEF patients was analyzed.Results LAD,LVDd,LVDs,E/A,LAVI and TRV in HFpEF group were(45.37±5.95)mm,(49.75±5.72)mm,(33.72±3.84)mm,(0.74±0.11),(45.52±5.53)ml/m^(2) and(2.94±0.31)m/s,which were higher than those of(32.82±4.85)mm,(41.51±5.28)mm,(26.16±3.43)mm,(0.52±0.09),(20.64±3.41)ml/m^(2) and(2.18±0.35)m/s in non-heart failure group;LVEF of(61.24±7.86)%in HFpEF group was lower than that of(68.23±7.98)%in non-heart failure group;the difference was statistically significant(P<0.05).There was no statistically significant difference in IVS and LVPW between the two groups(P>0.05).The serum BUA and NT-proBNP in HFpEF group were(486.88±68.91)μmol/L and(874.07±112.71)pg/ml,respectively,which were higher than those of(287.87±35.82)μmol/L an

关 键 词：射血分数保留的心力衰竭 超声心动图 血清学相关指标 心脏功能分级 

分 类 号：R541.6[医药卫生—心血管疾病] R540.45[医药卫生—内科学]