【摘要】 目的探讨临床评价慢性房颤患者的心功能全面、客观、量化指标。方法选择2007年1～7月苏州大学附属第一医院心内科慢性房颤患者75例(慢性房颤组)和门诊正常体检者20名(对照组)。所有入选者均采用我院心超室制订的综合超声心动图多项参数的心力衰竭超声指数进行评分,并将该评分、左心室射血分数(LVEF)、同期血浆脑钠肽(BNP)检测结果及纽约心功能分级进行比较。结果心力衰竭超声指数在慢性房颤组高于对照组(P<0.01),且随着纽约心功能分级的升高而升高,心功能I、Ⅱ、Ⅲ、Ⅳ级的慢性房颤患者的心力衰竭超声指数分别为1.47±0.92、2.53±1.06、3.68±1.19、4.82±1.24。Spearman相关性分析表明,心力衰竭超声指数与血浆BNP高度相关(r=0.86,P<0.01),与纽约心功能分级也呈高度相关(r=0.87,P<0.01);同期的LVEF与血浆BNP值呈负相关(r=-0.53,P<0.01),与纽约心功能分级也呈负相关(r=-0.49,P<0.01),其相关程度均显著低于心力衰竭超声指数与BNP及纽约心功能分级的相关性。结论心力衰竭超声指数作为评价慢性房颤患者心功能要比单一的LVEF更准确,值得临床推广应用。更多还原

【Abstract】 Objective To evaluate heart function of patients with chronic atrial fibrillation by heart failure echocardiography index(HFEI),which integrates multinominal parameter of echocardiography.The aim is to provide an impersonal,comprehensive and numerable criterion for evaluating heart function of patients with chronic atrial fibrillation.Methods This study consisted of 75 patients with chronic atrial fibrillation and 20 normal controls.All the subjects were graded by HFEI which was put forward by our hospital and the multinomial parameter of echocardiography was synthesized.At the same time,the scores of HFEI and left ventricular ejection fraction(LVEF)were compared with the outcomes of contemporaneous BNP and the NYHA class.Results The scores of HFEI in atrial fibrillation group were higher than those in control group(P<0.01)and increased with the growing of the NYHA functional class.The scores of patients with atrial fibrillation in NYHA class I,Ⅱ,Ⅲ,Ⅳ was 1.47±0.92,2.53±1.06,3.68±1.19,4.82±1.24 respectively.The results analysed by Spearman rank correlation showed that HFEI had remarkably positive correlation with BNP(r=0.86,P<0.01)and with NYHA class(r=0.87,P<0.01).LVEF had inverse correlation with BNP(r=-0.53,P<0.01)and with NYHA class(r=-0.49,P<0.01),the degree of whose correlation was prominently under that of HFEI with BNP and NYHA class.Conclusion HFEI is more accurate than LVEF in evaluting the heart function of patients with chronic atrial fibrillation,and it’s worth generalizing in clinic.更多还原