无创动脉僵硬度检测对评价慢性心力衰竭患者心功能不全的意义.docVIP

无创动脉僵硬度检测对评价慢性心力衰竭患者心功能不全的意义 夏小琦，杨成明，曾春雨，王旭开，方玉强 （第三军医大学大坪医院野战外科研究所心血管内科，重庆 400042） 摘要：目的 探讨应用动脉僵硬度检测仪评估动脉硬化程度的临床价值及慢性心力衰竭(chronic heart failure ,CHF)患者心功能不全的意义。方法 选择本科110例CHF患者，根据NYHA心功能分级分为Ⅱ、Ⅲ、Ⅳ级组。测量患者的心-踝血管指数(CAVI)、踝臂指数(ABI)、左室射血分数(LVEF)、抽静脉血查血浆醛固酮(ALD)、B型脑钠肽(BNP)及高敏C反应蛋白(Hs-CRP)浓度，并进行相关性分析。结果 心功能Ⅲ级组、Ⅳ级组CAVI-R和CAVI-L较Ⅱ级组明显升高（P0.05）。心功能Ⅲ级组、IV级组血浆ALD、BNP、Hs-CRP较Ⅱ级组明显升高（P0.05）。心功能Ⅲ级组、IV级组LVEF较Ⅱ级组明显降低（P0.05）。CAVI与ALD、BNP、Hs-CRP呈正相关（r=0.344，r=0.434，r=0.406，P0.05），与LVEF呈负相关（r=-0.678，P0.05）。结论 CAVI与ABI同样有评估动脉硬化程度的临床价值，并具有简便、可靠、无创性的优点，与传统的指标具有很好的相关性，能更全面的评估CHF患者的心功能。 关键词：动脉僵硬；慢性心功能不全；心-踝血管指数； 踝臂指数 中图法分类号：R543.5; R541; R540.4 Noninvasive arterial stiffness examination evaluates cardiac insufficiency in patients with chronic heart failure XIA Xiao-qi, YANG Cheng-ming, ZENG Chun-yu, WANG Xu-kai, FANG Yu-qiang (Department of Cardiology, Institute of Surgery Research, Daping Hospital, Third Millitary Medical University, Chongqing 400042, China) Abstract: Objective To investigate the significance of noninvasive arterial stiffness examination in patients with chronic heart failure (CHF). Methods A total of 110 patients with chronic heart failure and admitted in our hospital from January to October 2008 were subjected in ,this study. They were divided into 3 groups according to their cadiac function varied from class II-IV (NYHA). There were 50 patients in NYHA II group, 30 in III group, and 300in VI group. Measurement of these parameters, including the cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), left ventricular ejection fraction (LVEF), plasma aldosterone (ALD), B-type natriuretic peptide (BNP), high sensitive reaction protein C (Hs-CRP) were measured, and the relationship among these parameters were analyzed. Results CAVI in III group and IV group was obviously higher than that in group II (P0.05). Plasma ALD, BNP and Hs-CRP were significantly higher in the group III and group IV than in group II (P0.05). Color Doppler echocardiography indicated th