摘要
目的:观察慢性心力衰竭(CHF)不同时期无创血流动力学指标的变化规律,探讨相关指标检测的临床实用意义。方法:选取2014年3月-2016年10月空军总医院心脏中心住院的149例患者,根据ACC/AHA成人CHF分期标准将其归为A、B、C、D组共4组。另选同期我院健康体检者39例作为正常对照组,所有入组人员均行无创血流动力学、超声心动图、血浆BNP检测。比较分析CHF不同时期各指标的变化。结果:心衰各组与正常组比较无创血流动力学各指标差异有统计学意义(P<0.05);A、B组之间,A、B组与正常对照组之间BNP、EF值差异无统计学意义(P>0.05),C、D组与对照组、A、B组比较BNP明显升高,EF值明显降低,差异有统计学意义(P<0.05)。结论:慢性心力衰竭患者从A期高危险因素期心功能就受到一定程度的影响。随着心衰的进展,泵功能、心肌收缩力逐渐减低,前、后负荷逐渐增加;BNP及心脏超声LVEF在一定程度可反应心功能的改变,但心衰A期、B期疾病不敏感。到临床心衰期才开始出现BNP的增高,LVEF值的减低。无创血流动力学检测可为临床评估心功能提供客观参考指标。
Objective：To observe the changes of noninvasive hemodynamic indexes in patients with chronic heart failure（CHF）in different periods,and to explore the clinical significance of the related indexes.Methods：A total of 149 patients who had hospitalised in the heart center of General Hospital of the Air Force PLA during March 2014 to October 2016,were divided into A,B,C,D group according to the ACC/AHA Chronic Heart failure Guidelie,Anothersame physical examination in our hospital 39 cases as normal control group,all subjects underwent noninvasive hemodynamics,echocardiography and plasma BNP detection.Results：Heart failure groups were compared with the normal group,there were significant differences in invasive hemodynamics parameters（P〈0.05）;there was no significant A,B group and the control group difference in plasma BNP,EF（P〉0.05）,Plasma BNP in the C,D group was significantly higher than in other groups,EF value in the C,D group was significantly lower than in A,B and control groups.Conclusion：Patients with chronic heart failure appeared hemodynamic changes from the stages of high risk factors of heart failure,with the progression of heart failure,pump function,myocardial contractility decreased gradually,before-load and after-load increased gradually;BNP and cardiac ultrasound LVEF can reflect the cardiac function in a certain degree but they are not sensitive in A,B phase of chronic failure.To the clinical stage of heart failure BNP begans to increase,LVEF decrease.Noninvasive hemodynamic monitoring can provide objective reference for clinical evaluation of cardiac function.
出处
《医学理论与实践》
2017年第17期2497-2500,共4页
The Journal of Medical Theory and Practice
关键词
心力衰竭
心功能
血流动力学
Heart failure
Cardiac function
Hemodynamics
