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目的探讨心力衰竭超声指数在慢性心房颤动心功能评价中的作用,为房颤患者的治疗及判断预后提供依据。方法选择126例合并慢性心力衰竭的慢性房颤患者和36例门诊健康查体者(正常对照组)作为研究对象,对其进行心功能评价。观察比较两组的心脏结构、心力衰竭超声指数评分、血浆脑钠肽(BNP)水平。结果慢性房颤组随心功能分级的升高,左房内径(LAD)、左心室舒张末期内径(LVDd)、脑钠肽(BNP)、心力衰竭超声指数均逐渐增大,而左心室射血分数(LVEF)逐渐降低,差异均有统计学意义(P<0.05,P<0.01)。相关分析表明,心力衰竭超声指数与LAD、LVDd、BNP、心功能分级均呈明显正相关(r值分别为0.483,0.517,0.792,0.839;P<0.05,P<0.01),与LVEF呈明显负相关(r=-0.715,P<0.01)。结论心力衰竭超声指数用于慢性房颤患者心功能的评价具有无创伤、综合性、简便性、量化性的特点,可在临床广泛应用。
Objective To investigate the role of heart failure index in the assessment of cardiac function in patients with chronic atrial fibrillation and to provide evidence for the treatment and prognosis of patients with atrial fibrillation. Methods 126 cases of chronic atrial fibrillation patients with chronic heart failure and 36 cases of out-patient health check-up (normal control group) were selected as the research object, and their cardiac function was evaluated. The heart structure, the index of heart failure ultrasound index and the level of plasma brain natriuretic peptide (BNP) were compared between the two groups. Results LAD, LVDd, BNP and heart failure index increased gradually in patients with chronic atrial fibrillation, but left ventricular ejection fraction (LVEF) gradually decreased, the differences were statistically significant (P <0.05, P <0.01). Correlation analysis showed that the index of heart failure was positively correlated with LAD, LVDd, BNP and heart function (r = 0.483,0.517,0.792,0.839, P <0.05, P <0.01) (R = -0.715, P <0.01). Conclusion The application of heart failure ultrasound index in the evaluation of cardiac function in patients with chronic atrial fibrillation has the characteristics of noninvasiveness, comprehensiveness, simplicity and quantification. It can be widely used in clinical practice.