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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级组右侧肢体CAVI(CAVI-R)和左侧肢体CAVI(CAVI-L)较Ⅱ级组明显升高(P<0.05)。心功能Ⅲ级组、Ⅳ级组血浆ALD、BNP、Hs-CRP较Ⅱ级组明显升高(P<0.05)。心功能Ⅲ级组、Ⅳ级组LVEF较Ⅱ级组明显降低(P<0.05)。CAVI与ALD、BNP、Hs-CRP呈正相关(r=0.344,r=0.434,r=0.406,P<0.05),与LVEF呈负相关(r=-0.678,P<0.05)。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;CAVI与传统的指标具有很好的相关性,可作为评估CHF患者心功能的指标。
Objective To investigate the clinical value of assessing the degree of atherosclerosis by arterial stiffness tester and the significance of cardiac insufficiency in patients with chronic heart failure (CHF). Methods One hundred and ten patients with CHF undergraduate were enrolled in this study. Patients were divided into two groups according to NYHA functional class Ⅱ, Ⅲ and Ⅳ. Cardiac-ankle vascular index (CAVI), ankle-brachial index (ABI), left ventricular ejection fraction (LVEF), plasma aldosterone (ALD), BNP and hypersensitive C- Protein (Hs-CRP) concentration, and correlation analysis. Results The level of CAVI-CA and CAVI-L in right limbs of group Ⅲ and group Ⅳ were significantly higher than those of group Ⅱ (P <0.05). Plasma levels of ALD, BNP and Hs-CRP in grade Ⅲ and Ⅳ group were significantly higher than those in grade Ⅱ group (P <0.05). The levels of LVEF in grade Ⅲ group and grade Ⅳ group were significantly lower than those in grade Ⅱ group (P <0.05). There was a positive correlation between CAVI and ALD, BNP and Hs-CRP (r = 0.344, r = 0.434, r = 0.406, P <0.05) and negative correlation with LVEF (r = -0.678, P <0.05). Conclusions CAVI has the same clinical value as ABI in assessing the degree of atherosclerosis, and has the advantages of simplicity, reliability and noninvasiveness. CAVI has good correlation with traditional indexes and can be used as an index to evaluate the cardiac function in patients with CHF.