超声心动图与心电图及心衰标志物在诊断心力衰竭中的应用价值

Analysis of echocardiography,electrocardiography and heart failure markers in the diagnosis of heart failure

目的探讨超声心动图与心电图及心衰标志物在诊断心力衰竭中的应用价值。方法选取60例心力衰竭患者为心衰组,另选取60例健康人为正常组,对两组给予超声心动图与心电图及心衰标志物检查,观察并比较两组在三种检查中各项指标的变化情况。结果超声心动图检查中,心衰组患者与正常组相比,球形指数、左心室质量及室壁运动评分明显上升,左室压力上升速率、射血分数和心脏指数明显降低(P<0.01);心电图检查中,心衰组患者全部窦性心搏RR间期(SDNN)、RR间期平均值标准差(SDANN)较正常组明显降低,震荡初始值(TO)升高而震荡斜率(TS)下降,同时24 h的三角指数和最大心率(m HR)均显著升高(P<0.01);心衰标志物检查中,与正常组相比,心衰组患者血浆生长转化因子-15(GDF-15)和血清脑钠肽(BNP)显著上升(P<0.01)。结合超声心动图、心电图及心衰标志物共同诊断心力衰竭,灵敏度可达98.33%(59/60)。结论超声心动图与心电图及心衰标志物能有效对心力衰竭做出诊断。

Objective To evaluate the value of echocardiography,ECG and heart failure markers in the diagnosis of heart fail- ure. Methods Sixty patients with heart failure were selected as heart failure group and another 60 cases of healthy human as control group. Echocardiography and ECG and heart failure markers were examined in two groups and the changes of the indexes of the two groups were observed and compared. Results In the echocardiography examination, the left ventricular sphericity index and left ven- tricular mass of the heart failure patients increased significantly, and the left ventricular pressure rise rate, ejection fraction and cardiac index significantly decreased, and the wall motion score significantly increased （P 〈 0. 01 ）. In the ECG examination, the standard divia- tion of NN intervals （ SDNN）, RR interval mean standard deviation （SDANN） of heart failure group were significantly lower than those of contral group, with TO increasing and TS decreasing, while the triangular index and mHR 24 h significantly increased （P 〈 0. 01 ）. In the heart failure markers examination,the Plasma growth factor-15 （GDF-15） and BNP of heart failure group increased significantly（ P 〈 0. 01 ）. The sensitivity of using echocardiography, electrocardiography and heart failure markers were greatly improved than single one way in diagnosis of heart failure. Conclusion Echocardiography, ECG and heart failure markers effectively made a diagnosis of heart failure.