不同射血分数心衰的理化指标比较
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摘要
目的:研究心衰新分类下不同类型心衰临床理化指标是否具有差异,以更深入地认识心衰的病理生理特征和发病机制。方法:选取2016年8月至2017年6月在我院住院治疗的心衰病人56例,分为射血分数保留心衰组、射血分数中间值心衰组和射血分数降低心衰组,收集患者的一般情况、入院24 h内的理化检测指标进行统计学分析。结果:3组患者比较,BNP、LVEDD、血尿酸具显著性差异(均P<0.05);血β2微球蛋白、血胱抑素C、血肌酐、D-二聚体、cTnI无显著性差异(均P>0.05); EF值与BNP、LVEDD、血尿酸呈显著正相关(均P<0.05),EF值与其他指标无显著相关性(P>0.05)。结论:新分类中3组不同类型心衰EF值具有明显统计学差异,不同分组的严重程度也不同。BNP、LVEDD、血尿酸可以作为心衰分类的依据并用来指导心衰的治疗。
Objective:To study whether there are differences in clinical physiochemical indexes of different types of heart failure(HF) under the new classification of heart failure, so as to understand the pathophysiological characteristics and pathogenesis of heart failure more deeply.Methods:From August 2016 to June 2017, 56 inpatients in our hospital were allocated into three groups according to their LVEF: HFpEF group(HF with preserved EF), HFrEF group(HF with reduced EF) and HFmrEF group(HF with mid-range EF). The general condition of patients and physiochemical indexes within 24 h of admission were statistically analyzed.Results:There were significant differences in BNP, LVEDD and serum uric acid among the three groups(all P<0.05); there were no significant differences in serum beta-2 microglobulin, cystatin C, serum creatinine, D-dimer and cTnI(all P>0.05); EF was positively correlated with BNP, LVEDD and serum uric acid(all P<0.05), and it was not significantly correlated with other indexes(P>0.05).Conclusion:Under the new classification, EF values of three different HF types are significantly different, and the severity of different groups is also different. BNP, LVEDD and serum uric acid can be used as a basis for the HF classification and used to guide the HF treatment.
Objective:To study whether there are differences in clinical physiochemical indexes of different types of heart failure(HF) under the new classification of heart failure, so as to understand the pathophysiological characteristics and pathogenesis of heart failure more deeply.Methods:From August 2016 to June 2017, 56 inpatients in our hospital were allocated into three groups according to their LVEF: HFpEF group(HF with preserved EF), HFrEF group(HF with reduced EF) and HFmrEF group(HF with mid-range EF). The general condition of patients and physiochemical indexes within 24 h of admission were statistically analyzed.Results:There were significant differences in BNP, LVEDD and serum uric acid among the three groups(all P<0.05); there were no significant differences in serum beta-2 microglobulin, cystatin C, serum creatinine, D-dimer and cTnI(all P>0.05); EF was positively correlated with BNP, LVEDD and serum uric acid(all P<0.05), and it was not significantly correlated with other indexes(P>0.05).Conclusion:Under the new classification, EF values of three different HF types are significantly different, and the severity of different groups is also different. BNP, LVEDD and serum uric acid can be used as a basis for the HF classification and used to guide the HF treatment.
引文
[1]PONIKOWSKI P, VOORS A A, ANKER S D, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Kardiol Pol, 2016, 74(10): 1037-1147.
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[3]ZAMORA E, LUPóN J, URRUTIA A, et al. Estimated creatinine clearance: a determinant prognostic factor in heart failure[J]. Med Clin (Barc), 2008, 131(2): 47-51.
[4]HASHIMOTO T, ISHII J, OKUYAMA R, et al. Prognostic value of plasma concentration of D-dimer on admission for in-hospital mortality in patients hospitalized for worsening heart failure[J]. J Card Fail, 2012, 18(10): S178-S179.
[5]ZHANG Y, LI Y, CHENG G. Effect of low-dose diuretics on the level of serum cystatin C and prognosis in patients with asymptomatic chronic heart failure[J]. Exp Ther Med, 2015,10(6): 2345-2350.
[6]LI Z J, YI C J, LI J, et al. Serum uric acid level as a cardio-cerebrovascular event risk factor in middle-aged and non-obese Chinese men[J]. Oncotarget, 2017, 8(15): 24110-24118.
[7]KHAN A, SHAH M H, KHAN S, et al. Serum uric acid level in the severity of congestive heart failure (CHF)[J]. Pak J Med Sci, 2017, 33(2): 330-334.
[8]HUANG H, HUANG B T, LI Y L, et al. Uric acid and risk of heart failure: a systematic review and meta-analysis[J]. Eur J Heart Fail, 2014, 16(1): 15-24.
[9] MOJIMINIYI O A, ABDELLA N. Evaluation of cystatin C and β-2 microglobulin as markers of renal function in patients with type 2 diabetes mellitus[J]. Journal of Diabetes and its Complications, 2003, 17(3): 160-168.
[10]XIE L F, TERRAND J, XU B B, et al. Cystatin C increases in cardiac injury: a role in extracellular matrix protein modulation[J]. Cardiovasc Res, 2010, 87(4): 628-635.
[11]ZORLU A, YILMAZ M B, YUCEL H, et al. Increased D-dimer levels predict cardiovascular mortality in patients with systolic heart failure[J]. J Thromb Thrombolysis, 2012, 33(4): 322-328.
[2] FOSTER M C, CORESH J, HSU C Y, et al. Serum β-trace protein and β2-microglobulin as predictors of ESRD, mortality, and cardiovascular disease in adults with CKD in the Chronic Renal Insufficiency Cohort (CRIC) Study[J]. American Journal of Kidney Diseases, 2016, 68(1): 68-76.
[3]ZAMORA E, LUPóN J, URRUTIA A, et al. Estimated creatinine clearance: a determinant prognostic factor in heart failure[J]. Med Clin (Barc), 2008, 131(2): 47-51.
[4]HASHIMOTO T, ISHII J, OKUYAMA R, et al. Prognostic value of plasma concentration of D-dimer on admission for in-hospital mortality in patients hospitalized for worsening heart failure[J]. J Card Fail, 2012, 18(10): S178-S179.
[5]ZHANG Y, LI Y, CHENG G. Effect of low-dose diuretics on the level of serum cystatin C and prognosis in patients with asymptomatic chronic heart failure[J]. Exp Ther Med, 2015,10(6): 2345-2350.
[6]LI Z J, YI C J, LI J, et al. Serum uric acid level as a cardio-cerebrovascular event risk factor in middle-aged and non-obese Chinese men[J]. Oncotarget, 2017, 8(15): 24110-24118.
[7]KHAN A, SHAH M H, KHAN S, et al. Serum uric acid level in the severity of congestive heart failure (CHF)[J]. Pak J Med Sci, 2017, 33(2): 330-334.
[8]HUANG H, HUANG B T, LI Y L, et al. Uric acid and risk of heart failure: a systematic review and meta-analysis[J]. Eur J Heart Fail, 2014, 16(1): 15-24.
[9] MOJIMINIYI O A, ABDELLA N. Evaluation of cystatin C and β-2 microglobulin as markers of renal function in patients with type 2 diabetes mellitus[J]. Journal of Diabetes and its Complications, 2003, 17(3): 160-168.
[10]XIE L F, TERRAND J, XU B B, et al. Cystatin C increases in cardiac injury: a role in extracellular matrix protein modulation[J]. Cardiovasc Res, 2010, 87(4): 628-635.
[11]ZORLU A, YILMAZ M B, YUCEL H, et al. Increased D-dimer levels predict cardiovascular mortality in patients with systolic heart failure[J]. J Thromb Thrombolysis, 2012, 33(4): 322-328.