体质指数与急性心肌梗死后左心室功能的关系

Impact of body mass index on left ventricular function after acute myocardial infarction

目的观察体质指数(BMI)对急性心肌梗死后左心室功能的影响。方法入选首次急性心肌梗死患者共161例,根据BMI分为正常组(n=50)、超重组(n=85)与肥胖组(n=26)三组,所有患者分别于发病后72 h内、发病后30 d行超声心动图检查测量左心室舒张末期容积(LVEDV)和左心室射血分数(LVEF)及E峰/A峰。结果超重或肥胖组在入院时及30 d随访时的左室舒张末期容积均显著大于正常组(入院时:134.9 ml±33.4 ml/146.9 ml±60.6 ml比134.9 ml±33.4 ml,P=0.016;30 d随访时:149.9 ml±36.6 ml/159.4 ml±54.5 ml比136.0 ml±36.2 ml,P=0.030),超重或肥胖组在入院时及30 d随访时的LVEF水平均显著低于正常组(入院时:49.7%±7.7%或46.8%±7.1%比51.7%±7.6%,P=0.030;30 d随访时:52.9%±7.6%或50.88%±7.1%比55.3%±7.5%,P=0.042)。超重及肥胖组的E/A值与正常组相比在发病72 h及30 d随访时均无显著差异(入院时分别为:0.86±0.23、0.84±0.23比0.85±0.25,P=0.951;30 d随访时分别为:0.97±0.25、0.97±0.20比0.99±0.25,P=0.835)。结论合并超重或肥胖的急性心肌梗死患者的左心室的扩大与LVEF降低更为明显。

To study the impact of body mass index（BMI） on left ventricular function after onset of AMI. Methods The relationship between BMI and left ventricular function in 161 patients with AMI was studied. All these patients were grouped according to BMI into normal BMI group （ BMI 〈 24.0 kg/m2, n = 50）, overweight group （24.0 kg/m2〈 BMI 〈 28.0 kg/m2, n = 85） and obesity group （ BMI ≥28. Okg/ m2 , n = 26 ）. Left ventricular end diastolic volume （LVEDV） ,left ventricular ejection fraction（LVEF） and E/A ratio were measured at admission and at 30 days after the onset of AMI. Results Compared with normal BMI group, LVEDVs in overweight group and obesity group were increased （ at admission ： 134.9 ml± 33.4 ml or 146.9 ml± 60.6 ml vs 134.9 ml±33.4 ml, P = 0. 016 ; at 30 - days ： 149.9 ml ±36.6 ml or 159.4 ml ±54.5 ml vs 136.0 ml±36.2 ml, P = 0. 030） and LVEFs in overweight group and obesity group were lower （at admission： 49.7%±7.7% or 46.8% ±7.1% vs51.7% ±7.6%,P =0.030; at30-days： 52.9% ±7.6% or50.88% ±7.1% vs55.3% ±7.5%,P =0.042）. E/Aratios in overweight group and obesity group were not different from normal group （ at admission ：0.86±0.23 or 0.84±0.23 vs 0.85±0.25, P = 0. 951 ; at 30 - days ：0.97±O. 25 or 0.97±0.20 vs 0.99 ±0.25, P = O. 835 ）. Conclusion Higher BMI is associated with enlarged LVEDV and worse LVEF after the onset of acute myocardial infarction.