步速对左室射血分数降低的慢性心力衰竭患者预后的预测价值

Predictive value of gait speed for prognosis of sufferers with chronic heart failure and left ventricular reduced ejection fraction (HF-REF)

目的探讨步速对左室射血分数降低的慢性心力衰竭(HF-REF)患者预后的评估价值。方法选择在解放军第91医院诊疗的HF-REF患者196例,按照步速不同将患者分为快步速组(≥0.8 m/s)和慢步速组(<0.8 m/s),所有患者均接受常规治疗和心衰的随访管理,观察两组患者出院后心功能状态、生活质量、再入院率及死亡率。结果快步速组再入院率及死亡率明显低于慢步速组,两组比较差异具有统计学意义(P<0.05)。快步速组生活质量评分明显低于慢步速组,两组比较差异具有统计学意义(P<0.05)。出院时、出院后6个月及12个月快步速组LVEF、6-MWD水平均高于慢步速组,两组分别比较差异具有统计学意义(P<0.05)。出院时、出院后6个月及12个月快步速组NT-pro BNP及NYHA分级Ⅳ级水平均低于慢步速组,两组分别比较差异具有统计学意义(P<0.05)。结论高步速HF-REF患者临床预后更好,而低步速HF-REF患者临床预后则相对较差,步速可能是一种较好的风险预测因素。

Objective To explore the predictive value of gait speed for prognosis of sufferers with chronic heart failure and left ventricular reduced ejection fraction （HF-REF）.Methods 196 cases with HF-REF diagnosed and treated in No.91 PLA Hospital were selected and divided into quick gait speed group（≥0.8 m/s） and slow gait speed group（〈0.8 m/s） according to their gait speed.All sufferers received conventional treatment and follow-up management for heart failure.The cardiac function state, living quality, re-hospitalization rate and death rate of the two groups were observed.Results The re-hospitalization rate and death rate in the quick gait speed group were clearly lower than the slow gait speed group, and the differences between the two groups were of statistical significance （P 〈 0.05）. The living quality scores in the quick gait speed group were lower than the slow gait speed group, and the differences between the two groups were of statistical significance（P 〈 0.05）.The levels of LVEF and 6-MWD in the quick gait speed group at discharge time, 6 months and 12 months after discharge were higher than those in the slow gait speed group, and the differences between the two groups were of statistical significance（P〈 0.05）.The levels of NT-proBNP and grade IV of NYHA in the quick gait speed group at discharge time, 6 months and 12 months after discharge were lower than those in the slow gait speed group, and the differences between the two groups were of statistical significance（P〈 0.05）.Conclusion The HF-REF sufferers with quick gait speed have good clinical prognosis, while the HF-REF sufferers with slow gait speed have poor clinical prognosis, so gait speed can be a favorable risk prediction factor.