肺部超声用于分析不同心力衰竭类型的比较及其与其他指标的相关性

Comparison of lung ultrasound in the application of different types of heart failure and its correlation with other indicators

目的比较肺部超声在不同心衰(HF)类型中应用的差异,并分析肺部超声与其他指标的相关性。方法124例急性HF患者,射血分数(EF)保留型HF组(HFpEF)48例;EF减低型HF组(HFrEF)76例。比较2组间临床资料以及心肺超声指标的差异,并进一步分析肺水B线在两种HF类型中分别与氨基末端脑钠尿肽原(NT-proBNP)、E/e’和左室EF(LVEF)的相关性的差异。结果 HFpEF组和HFrEF组两组患者在基本临床资料方面均无明显统计学差异;HFpEF组的LVEF、室间隔厚度明显高于HFrEF组,而左室舒张末期内径、左室收缩末期内径、下腔静脉直径均明显小于HFrEF组。两组患者的左房前后径、E/A、肺动脉压(PAP)、E/e’和B线均无明显统计学差异。在HFpEF组中B线与E/e’的相关性优于NT-proBNP(r=0.886,r=0.755),而在HFrEF组中肺水B线与NTproBNP的相关性优于E/e’(r=0.829,r=0.737)。结论无论HFpEF,还是HFrEF,B线与NT-proBNP、E/e’均有良好的正相关性。

AIM To investigate the differences of lung ultrasound in different types of heart failure and to analyze the correlation between lung ultrasound and other indexes. METHODS 124 consecutive acute heart failure patients were divided into two groups, including preserved ejection fraction heart failure （HFpEF） and reduced ejection fraction heart failure （HFrEF）. To compare differences of the two groups in clinical data and cardiopulmonary ultrasound measurements, additional investigation was performed to evaluate whether there was a difference in correlating between B lines with N-terminal pro brain natriuretic peptide （NT-proBNP）,E/e＇, left ventricular ejection fraction （LVEF） in the two types of heart failure. RESULTS There was no significant difference in clinical data between HFpEF and HFrEF groups. The LVEF and interventricular septal thickness of the HFpEF group were significantly higher than that of the HFrEF group, but the left ventricular end-diastolic diameter, end-systolic diameter and inferior vena cava diameter were significantly smaller than that of HFrEF group. B lines had no significant differences between the two groups, The correlation between B lines and E/e＇ was better than NT-proBNP in HFpEF group （ r = 0. 886, r = 0. 755）, and the correlation between B lines and NT-proBNP was better than E/e＇ in the HFrEF group （r = 0. 829, r = 0. 737 ）. CONCLUSION There was a significant positive correlation between B lines and NT-proBNP, E/e＇ , regardless of HFpEF or HFrEF.