射血分数中间值的心力衰竭患者临床特征

Clinical characteristics of heart failure with median ejection fraction

目的探索射血分数中间值心力衰竭患者的临床特征。方法2015年1月至2016年1月入住本院心血管内科的心力衰竭（心衰，NYHA0II-IV级）患者209例，按其左心室射血分数（LVEF）分为射血分数保留心衰组（HFpEF，LVEF≥50％，53例）、射血分数中间值心衰组（HFmrEF，LVEF40％～49％，46例）、射血分数降低心衰组（HFrEF，LVEF〈40％，110例）；对照分析其临床资料。结果与HFpEF组相比，HFmrEF组冠心病、高血红蛋白者更多见，心超检查显示左房前后径、室间隔厚、左室后壁厚均偏低（均P〈0．05）;与HFrEF组相比，HFmrEF组年龄偏大[（71．28±10．81）岁比（63．81±13．38）岁1，多合并冠心病，其收缩压偏高，前脑利尿钠肽BNP水平、平均血小板体积、尿酸均偏低（均P〈0．05）；左房前后径、左室前后径、肺动脉压均偏低（均P〈0．05）。结论在住院心衰患者中，仅22．01％为HFmrEF患者，该组患者年龄较大，冠心病更常见。

Objective To investigate clinical characteristics of heart failure （ HF ） with median ejection fraction. Methods From January, 2015 to January, 2016, two hundred and nine patients with a discharge diagnosis of HF （ NYHA II-IV ） admitted into our hospital were collected. The patients were stratified by LVEF as preserved （HFpEF, LVEF I〉 50%, n=53 ） , median （ HFmrEF, LVEF 40%-49%, n=46 ） , and reduced （HFrEF, LVEF〈40%, n=110）. The clinical data were compared. Results Compared with the HFpEF group, the HFmrEF group had more patients with coronary disease, higher hemoglobin, and lower left atrium diameter, as well as lower interventricular septal thickness and left ventricular posterior wall thickness （ all P 〈 0.05 ） . Compared with the HFrEF group, the patients in the HFmrEF group were older [ （ 71.28 10.81 ） vs. （ 63.81 13.38 ） ], and more patients had coronary disease, as well as higher systolic blood pressure （ P 〈 0.05 ） ; besides, their BNP level, mean platelet volume, purine trione, left atrium diameter, left ventricular anteroposterior diameter, and pulmonary arterial pressure were lower （ all P 〈 0.05 ） Conclusions HFmrEF only accounted for 22.01% of the patients with HF. The clinical characteristics of HFmrEF in this study suggested that being older and having coronary disease might play important roles.