摘要
目的探讨扩张型心肌病(DCM)患者心功能的相关因素,掌握各项指标在评价心功能分级和判断心力衰竭严重程度的方法。方法根据NYHA心功能分级标准及患者临床表现,将138例DCM患者分为心功能Ⅱ级组(n=22)、心功能Ⅲ级组(n=86)、心功能Ⅳ级组(n=30),回顾性分析影响三组患者心功能的相关指标,评估脑利钠尿肽(BNP)、同型半胱氨酸(HCY)水平与心脏彩超测量值的相关性。结果三组患者的BNP、同型HCY、左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、肺动脉收缩压(PASP)的差异有统计学意义(P <0.05);而左心房收缩末期内径(LAESd)、右心室舒张末期内径(RVEDd)、右心房收缩末期内径(RAESd)、室间隔厚度(IVSD)、左室后壁厚度(LVPWTd)的差异无统计学意义(P>0.05);BNP与LVEDd、LVEF、LVPWTd存在相关性(P<0.05),而HCY与各项测量值无相关性。结论 BNP、HCY、LVEDd、LVEF、PASP在临床中可用于指导DCM患者心功能分级和判断心力衰竭严重程度,这为DCM患者进行病情危险分层、诊治及评估预后提供理论支持。
Objective To explore the related factors of cardiac function in patients with dilated cardiomyopathy (DCM) and to grasp the indicators and methods of evaluating the severity of heart function classification and judging the severity of heart failure.Methods According to NYHA cardiac function grading standards and clinical manifestations,138 patients with DCM were divided into a cardiac function Ⅱ group ( n =22),a cardiac function Ⅲ group ( n =86) and a cardiac function Ⅳ group ( n =30).A retrospective analysis was performed for correlated indicators affected the patients’ cardiac function of the three groups.The relativity among brain natriuretic peptide (BNP),homocysteine (HCY) levels and cardiac color Doppler measurements was assessed.Results There were significant differences in BNP,HCY,left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF),left ventricular short axis shortening rate (LVFS) and pulmonary artery systolic pressure (PASP) among the three groups of DCM patients (P<0.05),but there were no significant differences in left atrial end systolic diameter (LAESd),right ventricular end diastolic diameter (RVEDd),right atrial end systolic diameter (RAESd),interventricular septal thickness (IVSD),left ventricular posterior wall thickness (LVPWTd)(P>0.05).BNP was correlated with LVEDd,LVEF and LVPWTd (P<0.05),while HCY was not correlated with the measured values.Conclusion BNP,HCY,LVEDd,LVEF and PASP can be used to guide the classification of heart function and judge the severity of heart failure in DCM patients in clinical practice,which provides theoretical supports for the risk stratification,the diagnosis and treatment and the assessment of prognosis of DCM patients.
作者
黄妹丹
张文燕
何凤珍
陈宇晴
周尚蓉
潘兴寿
刘莉
程初勇
Huang Meidan;Zhang Wenyan;He Fengzhen;Chen Yuqing;Zhou Shangrong;Pan Xingshou;Liu Li;Cheng Chuyong(Graduate School of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)
出处
《右江民族医学院学报》
2019年第2期131-134,共4页
Journal of Youjiang Medical University for Nationalities
基金
国家自然科学基金地区项目(81560076)
广西高校中青年教师基础能力提升项目(2017KY0514)
2018年研究生创新项目(YCSW2018216)
关键词
心肌病
扩张型
心功能
利钠尿肽
脑
cardiomyopathy,dilated
cardiac function
natriuretic peptide,brain
