不同射血分数患者外周动脉反应性充血指数及其相关因素分析

Peripheral arterial reactive hyperemia index and its related factors in patients with different left ventricular ejection fraction

目的探讨不同射血分数患者的外周动脉反应性充血指数(reactive hyperemla index,RHI)及相关因素。方法连续纳入2020年10—12月北京市垂杨柳医院心内科住院患者287例,所有患者均使用Endo-PAT进行无创外周动脉张力测定得出RHI,通过心脏超声检查测量左心室射血分数(left ventricular ejection fraction,LVEF),根据LVEF水平分为LVEF<40%组、LVEF40%~50%组和LVEF>50%组,分析三组的一般资料、RHI及相关因素。结果三组比较,LVEF<40%组患者吸烟史、高血压病史、糖尿病史、冠心病危险因素≥3个患者的比例最高,差异有显著性(P<0.05)。LVEF<40%组患者超敏C反应蛋白水平高于LVEF40%~50%组与LVEF>50%组,LVEF40%~50%组高于LVEF>50%组;LVEF<40%组患者RHI低于LVEF40%~50%组与LVEF>50%组,LVEF40%~50%组低于LVEF>50%组,差异均有显著性(P<0.05)。RHI与LVEF水平呈显著正相关(r=0.162,P<0.05),与超敏C反应蛋白水平呈显著负相关(r=-0.227,P<0.05)。结论不同LVEF水平患者RHI差异显著,LVEF<40%的患者血管内皮功能障碍最严重,RHI与LVEF水平呈显著正相关,与超敏C反应蛋白水平呈显著负相关。

Objective To explore the peripheral arterial endotheial function and its related factors in patients with different left ventricular ejection fraction.Method From October 2020 to December 2020,287 inpatients were recruited consecutively in the department of cardiology in Chuiyangliu Hospital.Endo-PAT was used to calculate reactive hyperemia index(RHI).Left ventricular ejection fraction(LVEF)was evaluated by echocardiography.The patients were divided into three groups according to LVEF.The characteristics,RHI and its related factors of the three groups were analyzed.Result RHI in the LVEF<40%group,LVEF40%-50%group and LVEF>50%group were 1.47±0.28,1.73±0.26,and 2.21±0.37 respectively.The difference was significant(P<0.05).RHI was positively correlated with LVEF and negatively correlated with the hsCRP level(P<0.05).Conclusion RHI is significantly different in patients with different LVEF.Patients with LVEF<40%have severe vascular endothelial dysfunction.RHI was positively correlated with LVEF and negatively correlated with the hsCRP level.