缺血性心力衰竭气阴两虚血瘀证患者外周灌注指数的研究  

Study on peripheral perfusion index in patients with qi and yin deficiency and blood stasis syndrome of ischemic heart failure

作　　者：孟昊 尚菊菊[1] 刘红旭[1] 来晓磊[1] 仇盛蕾[1] 刘超 MENG Hao;SHANG Juju;LIU Hongxu;LAI Xiaolei;QIU Shenglei;LIU Chao(Beijing Hospital of Taditional Chinese Medicine,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《中华中医药杂志》2025年第3期1489-1493,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：首都医科大学科研培育基金项目(No.PYZ23171);2022年度北京中医药“十四五”重点专科项目(No.BJZKLC0011)。

摘　　要：目的:观察缺血性心力衰竭气阴两虚血瘀证患者与外周灌注相关指数的临床相关性。方法:选取2022年9月至2023年9月于首都医科大学附属北京中医医院心内科重症监护室住院的61例缺血性心力衰竭患者,根据临床辨证分为气阴两虚血瘀证组(30例)和非气阴两虚血瘀证组(31例),比较两组外周灌注指数(PPI)和脉搏灌注变异指数(PVI)的灌注指标差异及其在不同射血分数中的差异;明确灌注指标与住院时间、心力衰竭病程的相关性水平;利用Logistic回归和ROC曲线分析灌注指标对缺血性心力衰竭患者气阴两虚血瘀证的诊断价值。结果:缺血性心力衰竭患者PPI在气阴两虚血瘀证组显著小于非气阴两虚血瘀证组(P<0.05);PVI在气阴两虚血瘀证组显著大于非气阴两虚血瘀证组(P<0.05);缺血性心力衰竭气阴两虚血瘀证患者PPI在射血分数下降组显著小于射血分数正常组(P<0.05);PVI在射血分数下降组显著大于射血分数正常组(P<0.05);PPI与住院时间及心力衰竭病程呈负相关性(P<0.05);PVI与心力衰竭病程呈正相关(P<0.05)。ROC分析结果提示PPI、PVI对缺血性心力衰竭气阴两虚血痧瘀证患者有一定的诊断价值(PPI:AUC0.824,95%CI0.724~0.925,P<0.05;PVI:AUC0.938,95%CI0.879~0.998,P<0.05)。结论:观察灌注指标与缺血性心力衰竭患者气阴两虚血瘀证存在一定关联,与疾病的严重程度及住院转归相关,并且可以作为辅助辨证及评估病情的简便参考方法。Objective:To observe the clinical correlation between patients with qi and yin deficiency and blood stasis syndrome of ischemic heart faiure and peripheral perfusion related index.Methods:A total of 61 patients with ischemic heart failure who were hospitalized in the Cardiology Intensive Care Unit of Beijing Hospital of Taditional Chinese Medicine from September 2022 to September 2023 were selected and divided into 30 cases of qi and yin deficiency and blood stasis syndrome group and 31 cases of non qi and yin deficiency and blood stasis syndrome group based on clinical dialectics.The differences in peripheral perfusion index(PPI)and plethysmography variability index(PVI)of the two groups of subjects and their differences in different ejection fractions were compared;Clarify the correlation level between perfusion indicators and hospitalization time and heart failure course;Using Logistic regression and ROC curve analysis to assess the diagnostic value of perfusion indicators in patients with ischemic heart failure with qi yin deficiency and blood stasis syndrome.Results:The PPI of patients with ischemic heart failure was significantly lower in the qi and yin deficiency and blood stasis syndrome group than in the non qi and deficiency and blood stasis syndrome group(P<0.05).The PVI in the qi and yin deficiency and blood stasis syndrome group was greater than that in the non qi and yin deficiency and blood stasis syndrome group,and the difference was statistically significant(P<0.05).The PPI of patients with qi and yin deficiency and blood stasis syndrome in ischemic heart failure was lower in the group with decreased ejection fraction than in the group with normal ejection fraction,and the difference was statistically significant(P<0.05).The PVI in the group with decreased ejection fraction was higher than that in the group with normal ejection fraction,and the difference was statistically significant(P<0.05).PPI was negatively correlated with length of hospital stay and course of heart failure(P<0.05).PVI is not

关 键 词：气阴两虚血瘀证 缺血性心力衰竭 灌注指数 灌注变异指数 射血分数 

分 类 号：R259[医药卫生—中西医结合]