肝硬化患者左心室收缩功能与心功能分级肝脏硬度的关系分析

Analysis of the Relationship between Left Ventricular Systolic Function and Cardiac Function Grading and Liver Stiffness in Patients with Liver Cirrhosis

目的:探究肝硬化患者左心室收缩功能与心功能分级、肝脏硬度的关系。方法:以2020年7月至2022年6月47例肝硬化患者为研究对象,并以40例健康体检者为对照组,应用飞利浦iu-Ilite型号超声诊断仪检测患者心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)],应用aixplorer型彩色多普勒超声检测肝脏硬度,分析左心室收缩功能指标与心功能分级、肝脏硬度的相关性。结果:肝硬化组LVEDV、LVESV值大于对照组[(96.04±7.73)mL、(36.53±7.12)mL vs(91.26±7.89)mL、(31.02±7.58)mL],LVEF值小于对照组[(0.62±0.08)%vs(0.66±0.10)%,P<0.05];根据肝硬化患者NYHA心功能的不同将其分为Ⅰ级(20例)、Ⅱ级(16例)、Ⅲ级(11例)、Ⅳ级(5例),NYHA心功能分级Ⅲ、Ⅳ级患者LVEDD、LVEDV、LVESV值大于Ⅰ、Ⅱ级患者[(4.58±0.38)cm、(98.52±6.49)mL、(39.06±6.34)mL vs(4.34±0.35)cm、(94.24±7.05)mL、(35.22±6.05)mL],LVEF值小于Ⅰ、Ⅱ级患者[(0.60±0.04)%vs(0.63±0.05)%,P<0.05];肝硬化患者LVESV值与心功能分级呈正相关,LVEF值与心功能分级呈负相关(r=0.198、-0.206,P<0.05);根据Child-Pugh分级将肝硬化患者分为A级(15例)、B级(20例)及C级(12例),肝硬化患者的LVEDV、LVESV及肝脏硬度随肝功能分级的增加而增加,LVEF值随肝功能分级的增加而减小(P<0.05);肝硬化患者LVESV与肝脏硬度呈正相关,LVEF与肝脏硬度呈负相关(P<0.05)。结论:肝硬化患者左心室收缩功能减退,且其左心室收缩功能指标与心功能分级、肝脏硬度相关。

Objective:To explore the relationship between left ventricular systolic function and cardiac function grading and liver stiffness in patients with liver cirrhosis.Methods:From July 2020 to June 2022,47 patients with liver cirrhosis were selected as the research subjects,and 40 healthy subjects undergoing physical examination were enrolled as the control group.The cardiac function indicators(LVEDD,LVESD,LVEDV,LVESV,LVEF)were detected by iu-Ilite ultrasound diagnostic apparatus(Philips Company,Netherlands),and aixplorer color Doppler ultrasound was adopted to detect the liver stiffness,and the correlation of left ventricular systolic function indicators with cardiac function grading and liver stiffness was analyzed.Results:The LVEDV and LVESV of the liver cirrhosis group were higher than those of the control group[(96.04±7.73)mL vs(91.26±7.89)mL,(36.53±7.12)mL vs(31.02±7.58)mL]while the LVEF was lower than that of the control group[(0.62±0.08)%vs(0.66±0.10)%,P<0.05].According to the different NYHA cardiac function grading in patients with liver cirrhosis,they were divided into grade I(20 cases),grade II(16 cases),grade III(11 cases),and grade IV(5 cases).The LVEDD,LVEDV,and LVESV of patients with NYHA cardiac function grades III and IV were greater than those of patients with grades I and II[(4.58±0.38)cm vs(4.34±0.35)cm,(98.52±6.49)mL vs(94.24±7.05)mL,(39.06±6.34)mL vs(35.22±6.05)mL]while the LVEF was less than that of patients with grades I and II[(0.60±0.04)%vs(0.63±0.05)%,P<0.05].The LVESV of patients with liver cirrhosis was positively correlated with cardiac function grading while the LVEF was negatively correlated with cardiac function grading(r=0.198,-0.206,P<0.05).According to Child-Pugh grading,patients with liver cirrhosis were classified into grade A(15 cases),grade B(20 cases),and grade C(12 cases),and the LVEDV,LVESV,and liver stiffness of patients with liver cirrhosis were increased with the increase of liver function grading,while the LVEF was decreased with the increase of liver function grading(P<0.05).LVESV was positively correlated with liver stiffness,and LVEF was negatively correlated with liver stiffness in patients with liver cirrhosis(P<0.05).Conclusion:The left ventricular systolic function is decreased in patients with liver cirrhosis,and the left ventricular systolic function indicators are related to cardiac function grading and liver stiffness.