背景单纯性心动过速性心肌病(pTCM)的发病率较高,但对于pTCM与扩张型心肌病(DCM)的鉴别诊断及其发病的危险因素目前尚无较系统的研究。目的探讨pTCM的临床特点和发病危险因素。方法入选2016年1月—2017年12月在宁波市鄞州第二医院心内...背景单纯性心动过速性心肌病(pTCM)的发病率较高,但对于pTCM与扩张型心肌病(DCM)的鉴别诊断及其发病的危险因素目前尚无较系统的研究。目的探讨pTCM的临床特点和发病危险因素。方法入选2016年1月—2017年12月在宁波市鄞州第二医院心内科住院的pTCM患者为pTCM组(42例),并选取同时期在本院住院的DCM患者为DCM组(43例)、同时期在本院就诊的有心动过速但无心动过速性心肌病患者为对照组(57例),采集患者的病史、入院后临床资料、血液学检查及其他辅助检查结果。比较pTCM组与DCM组患者的性别、年龄、吸烟史、有无高脂血症史及N末端脑钠肽前体(NT-proBNP)、左心房内径、左心室舒张末期内径、左心室射血分数。比较pTCM组与对照组的性别、年龄、体质指数(BMI)、吸烟史、高脂血症病史、心肌肌钙蛋白I(cTnI)、24 h动态心电图(Holter)总心率、心动过速类型、心动过速占总心率的百分比;采用多因素Logistic回归分析分析pTCM发病的危险因素。结果 pTCM组年龄、左心室射血分数、左心房内径高于DCM组,NT-proBNP低于DCM(P<0.05)。pTCM组cTnI、24 h Holter总心率、心动过速占总心率的百分比均高于对照组(P<0.05)。多因素Logistic回归分析结果显示,cTnI、24 h Holter总心率、心动过速占总心率的百分比是pTCM发病的影响因素(P<0.05)。结论 pTCM对患者的左心室结构和功能的影响要小于DCM,患者年龄较DCM患者偏大,pTCM发病的危险因素为cTnI和24 h Holter总心率、心动过速占总心率的百分比。展开更多
Objective: To understand the role of urotensin Ⅱ(UⅡ) and proadrenomedullin N-terminal 20 peptide (PAMP), a fragment of proadrenomedullin (proADM) possessing biological activity, in the pathophysiological process of ...Objective: To understand the role of urotensin Ⅱ(UⅡ) and proadrenomedullin N-terminal 20 peptide (PAMP), a fragment of proadrenomedullin (proADM) possessing biological activity, in the pathophysiological process of congestive heart failure (CHF) by observing the variation of their plasma levels and exploring their interrelations. Methods: Plasma UⅡ and PAMP levels were measured by radioimmunoassay in 52 patients with CHF and 14 healthy subjects. Left ventricular ejection fraction (LVEF) and the ratio of E/A were determined by echocardiography. Results: The plasma UⅡ level was significantly lower in patients with CHF than the healthy subjects (1.5±1.0 pg/ml vs 4.3±1.2 pg/ml, P<0.05), while plasma PAMP level was significantly higher in the former group (30.6±5.8 pg/ml vs 21.0±6.6 pg/ml P<0.05). The levels of UⅡ and PAMP were parallel with the severity of CHF, and significant correlation of plasma levels of UⅡ with LVEF (r=0.530, P=0.000) and the ratio of E/A (r=0.618, P=0.000) was noted. LVEF and ratio of E/A were found to be inversely correlated with plasma PAMP levels in the patients (r=-0.568, P=0.000; r=-0.350, P=0.004). Also found was the significant correlation between plasma UⅡ and PAMP levels (r=-0.528, P=0.000). The treatment of the patients resulted in increased plasma UⅡ levels and lowered PAMP levels. Conclusion: The variations of plasma levels of UⅡ and PAMP are parallel with the severity of CHF, suggesting their cooperative actions in the pathophysiology of CHF.展开更多
文摘背景单纯性心动过速性心肌病(pTCM)的发病率较高,但对于pTCM与扩张型心肌病(DCM)的鉴别诊断及其发病的危险因素目前尚无较系统的研究。目的探讨pTCM的临床特点和发病危险因素。方法入选2016年1月—2017年12月在宁波市鄞州第二医院心内科住院的pTCM患者为pTCM组(42例),并选取同时期在本院住院的DCM患者为DCM组(43例)、同时期在本院就诊的有心动过速但无心动过速性心肌病患者为对照组(57例),采集患者的病史、入院后临床资料、血液学检查及其他辅助检查结果。比较pTCM组与DCM组患者的性别、年龄、吸烟史、有无高脂血症史及N末端脑钠肽前体(NT-proBNP)、左心房内径、左心室舒张末期内径、左心室射血分数。比较pTCM组与对照组的性别、年龄、体质指数(BMI)、吸烟史、高脂血症病史、心肌肌钙蛋白I(cTnI)、24 h动态心电图(Holter)总心率、心动过速类型、心动过速占总心率的百分比;采用多因素Logistic回归分析分析pTCM发病的危险因素。结果 pTCM组年龄、左心室射血分数、左心房内径高于DCM组,NT-proBNP低于DCM(P<0.05)。pTCM组cTnI、24 h Holter总心率、心动过速占总心率的百分比均高于对照组(P<0.05)。多因素Logistic回归分析结果显示,cTnI、24 h Holter总心率、心动过速占总心率的百分比是pTCM发病的影响因素(P<0.05)。结论 pTCM对患者的左心室结构和功能的影响要小于DCM,患者年龄较DCM患者偏大,pTCM发病的危险因素为cTnI和24 h Holter总心率、心动过速占总心率的百分比。
基金This study is a subitem of Key Basic Research and Development Project of National "973" Program of China (G200056905 )
文摘Objective: To understand the role of urotensin Ⅱ(UⅡ) and proadrenomedullin N-terminal 20 peptide (PAMP), a fragment of proadrenomedullin (proADM) possessing biological activity, in the pathophysiological process of congestive heart failure (CHF) by observing the variation of their plasma levels and exploring their interrelations. Methods: Plasma UⅡ and PAMP levels were measured by radioimmunoassay in 52 patients with CHF and 14 healthy subjects. Left ventricular ejection fraction (LVEF) and the ratio of E/A were determined by echocardiography. Results: The plasma UⅡ level was significantly lower in patients with CHF than the healthy subjects (1.5±1.0 pg/ml vs 4.3±1.2 pg/ml, P<0.05), while plasma PAMP level was significantly higher in the former group (30.6±5.8 pg/ml vs 21.0±6.6 pg/ml P<0.05). The levels of UⅡ and PAMP were parallel with the severity of CHF, and significant correlation of plasma levels of UⅡ with LVEF (r=0.530, P=0.000) and the ratio of E/A (r=0.618, P=0.000) was noted. LVEF and ratio of E/A were found to be inversely correlated with plasma PAMP levels in the patients (r=-0.568, P=0.000; r=-0.350, P=0.004). Also found was the significant correlation between plasma UⅡ and PAMP levels (r=-0.528, P=0.000). The treatment of the patients resulted in increased plasma UⅡ levels and lowered PAMP levels. Conclusion: The variations of plasma levels of UⅡ and PAMP are parallel with the severity of CHF, suggesting their cooperative actions in the pathophysiology of CHF.
