射血分数正常心力衰竭的超声心动图指标与中医辨证分型的相关性研究

Correlative study of heart failure with normal left ventricular ejection fraction in TCM syndrome differentiations with echocardiography parameters

目的:探讨射血分数正常心力衰竭(heart failure with normal ejection fraction,HFNEF)患者中医辨证分型与超声心动图指标的相关性。方法:将我院收治的118例HFNEF患者分为心气阴虚证、心肾阳虚证、气虚血瘀证、阳虚水泛证4组,对各证型的超声心动图指标及实验室指标血浆B型钠尿肽(BNP)数据行统计学分析。结果:HFNEF患者各证型的年龄和心功能分级构成比差异有统计学意义,心气阴虚证、心肾阳虚证、气虚血瘀证、阳虚水泛证4组心功能呈逐渐减低趋势;各证型患者均有心脏收缩和舒张功能的异常,其中左房容积指数、二尖瓣环收缩期平均速度(s’mean)、二尖瓣环舒张晚期峰值速度(a’mean)、舒张早期二尖瓣口血流速与二尖瓣环平均速度比(E/e’mean)和血浆B型钠尿肽差异有统计学意义(P<0.05)。结论:HFNEF的中医证型与超声心动图指标及血浆BNP具有一定的相关性,超声心动图可作为中医辨证分型的客观量化指标。

Objective：To evaluate the correlation between TCM syndrome differentiations with echocardiography parameters of heart failure with normal left ventricular ejection fraction. Methods： 118 cases of HFNEF were devided into four TCM （the tra- ditional Chinese medicine）syndrome types： Qi Yin deficiency, Yang deficiency of heart and kidney, deficiency of Qi and blood stasis,edema syndrome due to Yang Deficiency. The echocardiography indexes and BNP data for each type were statistically an- alyzed. Results： Constituent ratio had significant difference in age and heart function classification of various types, their heart function showed a trend of gradual deterioration. All the patients had abnormal systolic and diastolic function of the heart. There were significant differences between various type for s＇ a ＇ LAVI, E/e ＇ and BNP （P~ 0.05 ）. Conclusion ： TCM syn- drome type has certain correlation to echocardiography index and BNP. The echocardiography can be used as objective and quan- titative indexes of Syndrome differentiation of TCM.