缺血性心脏病合并心力衰竭患者冠脉病变特点

发布时间：2018-11-17 12:29

【摘要】：目的比较缺血性心脏病合并不同类型心力衰竭患者的冠脉病变程度差异。方法对2015年1月至2016年5月在郑州人民医院心内科住院并行冠脉造影确诊为冠心病的心力衰竭患者282例进行回顾性分析,根据左室射血分数水平及B型利钠肽(brain natriuretic peptide,BNP)、血浆氨基酸末端脑钠肽前体(plasma N-terminal pro brain natriuretic peptide,NT-proBNP)等检查结果分为射血分数中间值心衰(heart failure with mid-range ejection fraction,HFmrEF)组89例,射血分数降低心衰(heart failure with reducedejection fraction,HFrEF)组109例,射血分数保留心衰(heart failure with preserved ejection fraction,HFp EF)组84例。比较临床基本资料(年龄、性别等)、心脏彩超及冠状动脉病变(血管病变数目、gensini积分、SYN-TAX积分)的差异。结果 HFpEF、HFmrEF、HFrEF组gensini积分分别为30.45±33.18、62.12±41.25、86.72±38.80,差异有统计学意义(P0.05),且3组间两两比较差异均具有统计学意义。HFp EF、HFmrEF、HFrEF组SYNTAX积分分别为11.77±8.39、19.08±8.39、26.41±10.31,与HFp EF组相比SYNTAX积分均较高,差异具有统计学意义(P0.05),且两两间比较差异均具有统计学意义(P0.05)。HFrEF、HFmrEF患者病程长短、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(leftventricular end systolic diameter,LVESD)、左心室质量指数(left ventricular mass index,LVMI)、血管病变数目、BNP、NT-proBNP明显高于HFp EF组。多变量相关分析提示SYNTAX积分与心功能分级、BNP、NT-proBNP、LVEF相关。Gensini积分与心功能分级、BNP、NT-proBNP相关。结论随着冠脉病变严重及复杂程度的加重,心力衰竭的程度加重。冠状动脉病变复杂及严重程度是缺血性心脏病患者发生心力衰竭的重要因素。
[Abstract]:Objective to compare the severity of coronary artery disease in patients with ischemic heart disease complicated with different types of heart failure. Methods from January 2015 to May 2016, 282 patients with heart failure diagnosed by coronary angiography in Department of Cardiology, Zhengzhou people's Hospital, were analyzed retrospectively, according to left ventricular ejection fraction (LVEF) and type B natriuretic peptide (brain natriuretic peptide,BNP). The plasma amino acid terminal brain natriuretic peptide precursors (plasma N-terminal pro brain natriuretic peptide,NT-proBNP) were divided into two groups: 89 patients with heart failure (heart failure with mid-range ejection fraction,HFmrEF), and 89 patients with heart failure with decreased ejection fraction (heart failure with reducedejection fraction,). HFrEF group (109 cases) and ejection fraction (heart failure with preserved ejection fraction,HFp EF) group (84 cases). The differences of clinical data (age, sex, etc.), color Doppler echocardiography and coronary artery disease (number of vascular lesions, gensini score, SYN-TAX score) were compared. Results the gensini score of HFpEF,HFmrEF,HFrEF group was 30.45 卤33.18 卤62.12 卤41.25 卤86.72 卤38.80 respectively, the difference was statistically significant (P0.05), and the differences among the three groups were statistically significant. HFp EF,HFmrEF,. The SYNTAX score of HFrEF group was 11.77 卤8.39 卤8.39 卤19.08 卤8.39 卤26.41 卤10.31, which was significantly higher than that of HFp EF group (P0.05), and the difference between the two groups was statistically significant (P0.05). HFrEF,). Duration of HFmrEF, left ventricular end-diastolic diameter (left ventricular end diastolic diameter,LVEDD), left ventricular end-systolic diameter (leftventricular end systolic diameter,LVESD), left ventricular mass index (left ventricular mass index,LVMI), number of vascular lesions, BNP, NT-proBNP was significantly higher in HFp EF group than in HFp EF group. Multivariate correlation analysis showed that SYNTAX integral was correlated with cardiac function grade, BNP,NT-proBNP,LVEF score was correlated with cardiac function grade, Gensini integral was correlated with cardiac function grade and BNP,NT-proBNP score. Conclusion the severity of heart failure increases with the severity and complexity of coronary artery disease. The complexity and severity of coronary artery disease is an important factor of heart failure in patients with ischemic heart disease.
【作者单位】：新乡医学院;郑州人民医院心内科;南方医科大学;
【基金】：郑州市创新型科技人才队伍建设项目(编号:096SYJH33114)
【分类号】：R541

【相似文献】