心脏超声影像用于评估重症急性左心收缩功能不全患者生存状况的临床应用价值

The Value of Ultrasonography in Evaluating the Survival of Patients with Severe Acute Left Ventricular Systolic Dysfunction

目的:探讨心脏超声影像用于评估重症急性左心收缩功能不全患者生存状况的应用价值。方法:选取2015年10月至2016年10月我院ICU收治的153例急性左心收缩功能不全患者作为研究对象,根据其心脏超声的不同表现分为全心弥漫抑制、左心弥漫抑制、冠状动脉相关节段抑制、非冠状动脉相关节段抑制,记录和比较患者1个月的病死率。结果:153例重症急性左心收缩功能不全患者,心脏超声表现为全心弥漫抑制者45例,左心弥漫抑制者35例,冠状动脉相关节段抑制者36例,非冠状动脉相关节段抑制者37例。全心弥漫抑制者1个月病死率为33.3%,左心弥漫抑制者1个月病死率为14.3%,冠状动脉相关节段抑制者1个月病死率为13.9%,非冠状动脉相关节段抑制者1个月病死率为8.1%,组间比较差异有统计学意义(P<0.05)。合并基础左室舒张功能不全者病死率为62.5%,高于未合并基础左室舒张功能不全者(13.5%,P<0.05)。结论:心脏超声影像可用于评估重症急性左心收缩功能不全患者的生存状况。

Objective: To evaluate The value of ultrasonography in evaluating the survival of patients with severe acute left ventricular systolic dysfunction. Methods: 153 patients with severe acute left ventricular systolic dysfunction in ICU of our hospital from October 2015 to October 2016 were selected s as the research object, and they were divided into whole diffuse heart inhibition, left diffuse inhibition, coronary artery related segment inhibition, coronary artery non-related segment inhibition were according to echocardiography result. Their mortality rates at 1 month were recorded. Results: Among 153 patients with severe acute left ventricular systolic insufficiency, cardiac ultrasound showed total diffuse inhibition in 45 cases, left ventricular diffuse inhibition in 35 cases, coronary artery related segmental inhibition in 36 cases, and non-coronary artery related segmental inhibition in 37 cases. The one-month mortality of patients with whole-heart diffuse inhibition was 33.3%, that of those with left-heart diffuse inhibition was 14.3%, that of those with coronary artery segmental inhibition was 13.9%, and that of those without coronary artery segmental inhibition was 8.1%. The difference between the two groups was statistically significant(P<0.05). The mortality of patients with left ventricular diastolic dysfunction combined with foundation was 62.5%, higher than that of those without foundation diastolic dysfunction(13.5%), and the difference was statistically significant(13.5%, P<0.05). Conclusion: Echocardiography could help to assess the survival condition of patients with severe acute left ventricular systolic dysfunction, which is worthy of clinical application.