舒张性心力衰竭与收缩性心力衰竭临床特征的比较

Clinical characteristics and cardiac function evaluation in patients with diastolic heart failure and systolic heart failure

目的:探讨舒张性心力衰竭和收缩性心力衰竭患者临床特征的差异。方法:选择心力衰竭患者253例,其中舒张性心力衰竭118例,收缩性心力衰竭135例。登记患者的临床资料,分析各组患者临床特征的差异。所有患者均检测N末端脑钠尿肽前体(NT-proBNP)及高敏C反应蛋白(hs-CRP)。结果:舒张性心力衰竭和收缩性心力衰竭均以老年患者居多,前者以女性多见(56.8%),并发高血压病(81.4%)及心房颤动(26.3%)均高于于后者(前项P<0.01,后项P<0.05),并发冠心病(45.8%)少于后者(P<0.01);两组NT-proBNP及hs-CRP均随着NYHA心功能分级增加而显著升高(P<0.01),舒张性心力衰竭组NT-proBNP低于收缩性心力衰竭组(P<0.01),但hs-CRP两组间差异无统计学意义。结论:与收缩性心力衰竭相比,舒张性心力衰竭于老年女性更多见,高血压病患病率及心房颤动发生率较高,NT-proBNP水平较低。

AIM： To explore the clinical characteristics and cardiac function evaluation in patients with diastolic heart failure （DHF） and systolic heart failure （SHF）. METHODS： A total of 253 patients with heart failure were selected including 118 DHF cases and 135 SHF cases, and 50 cases confirmed without organic heart disease served as control. Clinical data of patients were recorded and the differences of clinical characteristics between groups were analyzed. NT-proBNP and hs-CRP were detected in all patients. RESULTS： Both DHF and SHF were more common in elderly patients, but DHF was more common in females （ 56. 8% ）. There were more patients with hypertension （ 81.4% ） or atrial fibrillation （26. 3% ） in DHF group than in SHF group （P 〈0.01 ; P 〈0. 05, respectively） and patients accompanied with CHD （45.8%） in DHF were less than those in SHF （P 〈0. 01 ）. Compared with those in the control group, NT-proBNP and hs-CRP in both DHF group and SHF group were significantly higher （P 〈 0.01 ）, but NT-proBNP in DHF group was lower than that in the SHF group （ P 〈 0. 01 ）. No significant difference was found in Hs-CRP between groups. CONCLUSION： DHF is more common in elderly females, which is often accompanied by hypertension or atrial fibrillation. NT-proBNP and hs-CRP can be used as indicators of the evaluation of heart failure both in DHF and in SHF.