慢性心力衰竭患者左室射血分数与中医证型关系的研究

Study of correlation of LVEF with traditional Chinese medicine syndrome types in patients with chronic heart failure

目的分析慢性心力衰竭(CHF)患者左室射血分数(LVEF)与不同中医证型间的相关性,探讨LVEF、B型钠尿肽(BNP)作为CHF中医辨证分型客观指标的可行性。方法对117例CHF患者(CHF组)进行中医辨证分型,另外选取健康体检者23例作为对照组,均进行心脏彩超检查测定LVEF,并同时抽取血液采用免疫荧光法测定BNP,对结果进行统计学分析。结果 CHF组LVEF明显低于对照组,LVEF随心力衰竭加重而降低,与NYHA心功能分级呈负相关(r=-0.627,P<0.001)。LVEF与中医证型间存在负相关关系(r=-0.679,P<0.001),LVEF按照中医辨证分型加重程度逐级递减。CHF组BNP水平明显高于对照组,BNP的水平随心力衰竭加重而上升,与NYHA心功能分级呈正相关(r=0.813,P<0.001)。BNP水平与中医证型间存在正相关性(r=0.773,P<0.001),BNP水平按中医辨证分型加重程度逐级递增。结论 CHF患者心功能指标LVEF、BNP水平与中医证型有相关性,可作为CHF中医辨证分型的客观化指标。

Objective It is to investigate the possibility of left ventricular ejection fraction（LVEF） as a objective indicator for traditional Chinese medicine（TCM） syndrome types and to analyze the relation between LVEF level and TCM syndrome types in patients with chronic heart failure（CHF）.Methods One hundred and seventeen cases of patients with CHF（CHF group） were analyzed with TCM syndrome differentiation,otherwise 23 cases of healthy people were chosen as control group.LVEF in both groups were examined with cardiac color doppler ultrasound and blood BNP level was determined quantitatively with immunofluorescence assay.The results were analyzed with statistics method.Results The LVEF in patients with CHF were significantly lower than that in healthy controls.LVEF reduced when TCM syndrome differntiation severity get worse and were negatively correlated with the NYHA classification system（r=-0.627,P0.001）.The LVEF were negatively correlated with TCM Syndrome typing（r=-0.679,P0.001）.The BNP concentrations in patients with CHF were significantly higher than that in healthy controls.The BNP concentration was positively correlated with TCM Syndrome typing（r=0.773,P0.001）.It increased when TCM syndrome differntiation severity get worse and was positively correlated with the NYHA classification system（r=0.813,P0.001）.Conclusion There was a relationship among LVEF and BNP level and TCM syndrome types in patients with CHF,LVEF and BNP level might be objective indicators for TCM syndrome type in patients with CHF.