应用心衰超声指数评价舒张性心力衰竭的临床价值

Assess the clinical diagnostic value of heart failure echocardiography index for diastolic dysfunction

目的采用综合超声心动图多项参数的心衰超声指数来评价舒张性心力衰竭患者的心功能,为临床评价慢性心功能不全提供一个更为全面、客观、量化的指标。方法选取2003年6月至2005年10月江苏省苏州大学附属第一医院心内科舒张性心力衰竭患者75例和正常组37例,所有入选者均采用我院制订的综合超声心动图多项参数的心衰超声指数进行评分,并将该评分与同期血浆BNP检测结果及纽约心功能分级进行比较。结果心衰超声指数在舒张性心衰组明显高于正常组(P<0.01),且随着纽约心功能分级的升高而升高,心功能Ⅱ、Ⅲ、Ⅳ级患者的心衰超声指数值分别为2.00±0.87、3.28±0.90、5.29±1.50。相关性分析表明心衰超声指数与血浆BNP高度相关(r=0.86)。结论应用心衰超声指数结合临床表现诊断舒张性心力衰竭的严重程度是可行的,心衰超声指数作为评价慢性心功能不全的一个新指标值得临床推广应用。

Objective To evaluate the heart function of patients who had diastolic dysfunction. Using heart failure echocardiography index （HFEI）, which synthesizes the muhinomial parameter of eehoeardiography. The aim is to provide an impersonal, comprehensive and numerable criterion for appraising chronic congestive heart failure, Methods Totally 75 patients with diastolic dysfunction and 37 normal controls were involved in the study. All the subjects were graded by heart failure eehoeardiography index （HFEI） which was put forward by our hospital and the muhinomial parameter of eehocardiography was synthesized. At the same time, the scores of heart failure eehoeardiography index （HFEI） were compared with the outcomes of contemporaneous BNP and the NYHA class. ResuIts The scores of heart failure echocardiography index （HFEI） in diastolic dysfunction group were higher than those in control group （P 〈0. 01 ） and increased with the growing of the NYHA functional class. The scores of patients in NYHA class Ⅱ , Ⅲ, Ⅳ was 2.00 ± 0. 87, 3.28 ±0. 90, 5.29 ± 1.50 respectively. The results analysed by Spearman rank correlation showed that heart failure eehoeardiography index （HFEI） and BNP had remarkable correlation （ r = 0. 86 ）. ConcIusion It is feasible to evaluate the degree of diastolic dysfunction by combining heart failure eehoeardiography index （ HFEI ） with clinical symptom, and it＇s worth generalizing in clinic.