慢性心力衰竭患者心肌能量代谢变化与心脏收缩功能及左心室重构的相关性  

Correlation between changes in myocardial energy metabolism and cardiac systolic function,left ventricular remodeling in patients with chronic heart failure

作　　者：程进波 李红莲 张艳 CHENG Jin-bo;LI Hong-lian;ZHANG Yan(Department of Ultrasound,The First Hospital of Nanping City,Nanping Fujian 353000,China;Department of Ultrasound,The First Hospital of Jianyang District,Nanping City,Nanping Fujian 353000,China)

机构地区：[1]南平市第一医院超声科,福建南平353000 [2]南平市建阳区第一医院超声科,福建南平353000

出　　处：《临床和实验医学杂志》2024年第7期686-690,共5页Journal of Clinical and Experimental Medicine

基　　金：福建省自然科学基金项目(编号:2021J01872)。

摘　　要：目的分析慢性心力衰竭患者心肌能量代谢(MEE)变化与心脏收缩功能及左心室重构的相关性。方法回顾性选取2021年3月至2022年12月南平市第一医院收治的100例慢性心力衰竭患者作为观察组,选取同期来本院进行体检的85名健康体检者作为对照组。比较两组研究对象的左心室收缩末圆周室壁应力(cESS)、MEE、血清游离脂肪酸(FFA)、血清糖类抗原125(CA125)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室质量指数(LVMI)、左心室射血分数(LVEF)、每搏输出量、短轴缩短率及射血时间水平;采用Pearson相关分析,分析慢性心力衰竭患者心肌能量代谢变化与心脏收缩功能及左心室重构的相关性。结果观察组患者cESS、MEE、FFA及CA125水平分别为(194.35±30.25)kdyne/cm^(2)、(128.37±23.69)cal/min、(850.41±150.35)μmol/L、(68.54±5.33)kU/L,均高于对照组[(79.44±50.69)kdyne/cm^(2)、(68.57±12.97)cal/min、(227.31±40.57)μmol/L、(17.25±2.70)kU/L],差异均有统计学意义(P<0.05)。观察组患者LVEDd、LVESd、LVMI分别为(71.58±12.45)mm、(67.55±12.74)mm、(140.33±25.64)g/m^(2),均高于对照组[(42.05±8.46)mm、(41.39±8.16)mm、(77.59±13.58)g/m^(2)],LVEF、每搏输出量、短轴缩短率及射血时间分别为(38.49±7.64)%、(48.69±12.46)mL、(18.53±2.14)%、(181.31±18.49)ms,均低于对照组[(68.14±12.18)%、(68.67±15.04)mL、(36.05±2.34)%、(320.45±20.14)ms],差异均有统计学意义(P<0.05)。经过Pearson相关分析,cESS、MEE、FFA均与LVEDd、LVESd、LVMI、CA125呈正相关(P<0.05),cESS、MEE、FFA均与LVEF、每搏输出量、短轴缩短率、射血时间呈负相关(P<0.05)。结论慢性心力衰竭患者MEE、心脏收缩功能及左心室重构均发生异常,且MEE与心脏收缩功能、左心室重构密切相关。Objective To analyze the correlation between changes in myocardial energy metabolism(MEE) and cardiac systolic function,left ventricular remodeling in patients with chronic heart failure.Methods A total of 100 patients with chronic heart failure,admitted to The First Hospital of Nanping City from March 2021 to December 2022,were selected as the observation group,and 85 patients who came to our hospital for physical examination during the same period were selected as the control group.The left ventricular end systolic circumferential end-systolic wall stress(cESS),MEE,serum free fatty acids(FFA),serum carbohydrate antigen 125(CA125),left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),stroke output,short axis shortening rate,and ejection time levels were compared between two study groups,and the correlation between changes in myocardial energy metabolism and cardiac systolic function,left ventricular remodeling in patients with chronic heart failure were analyzed.Results The levels of cESS,MEE,FFA,and CA125 in the observation group were(194.35±30.25) kdyne/cm^(2),(128.37±23.69) cal/min,and(850.41±150.35) μmol/L,(68.54±5.33) kU/L,respectively,which were higher than those in the control group [(79.44±50.69) kdyne/cm^(2),(68.57±12.97) cal/min,(227.31±40.57) μmol/L,(17.25±2.70) kU/L,the differences were statistically significant(P<0.05).The LVEDd,LVESd,and LVMI of the observation group were(71.58±12.45) mm,(67.55±12.74) mm,and(140.33±25.64) g/m^(2),respectively,which were higher than those of the control group [(42.05±8.46) mm,(41.39±8.16) mm,and(77.59±13.58) g/m^(2)],LVEF,stroke output,short axis shortening rate,and ejection time were(38.49±7.64)%,(48.69±12.46) mL,(18.53±2.14)%,and(181.31±18.49) ms,respectively,which were lower than those of the control group [(68.14±18.49) ms,(68.67±15.04) mL,(36.05±2.34)%,(320.45±20.14) ms],the differences were statistically significant(P<0.05).

关 键 词：慢性心力衰竭 心肌能量代谢 心脏收缩功能 左心室重构 左室收缩末圆周室壁应力 血清游离脂肪酸 左心室舒张末期内径 短轴缩短率 

分 类 号：R541.6[医药卫生—心血管疾病]