| 摘要: |
| ［摘要］目的 探讨射血分数保留的心力衰竭 （heart failure with preserved ejection fraction，HF-PEF）与射血分数降低的心力衰竭 （heart failure with reduced ejection fraction，HF-REF）及临界HF-PEF （HF-PEF， borderline）的临床特征的差异．方法 回顾性分析2013年 8月至2015年8月玉溪市人民医院心内科住院的已确诊为慢性心力衰竭的患者共222例．根据患者心脏超声检查所测LVEF值，将研究对象分为HF-PEF组81例；临界HF-PEF组70例；HF-REF组71例．入选患者均接受心脏超声、12 导同步体表心电图、血生化等的检测，并记录患者的临床资料，分析比较3组患者临床特征差异．结果（1）HF-PEF与HF-REF患者在年龄、性别、职业构成比，吸烟史所占比例，体重指数（BMI），基础病因中的冠心病、高血压所占比例，房颤发生率及心功能分级构成比，收缩压水平，心率的比较，差异均有统计学意义（P＜0.05）；（2）与HF-PEF 患者相比较，HF-REF 患者的E/A（二尖瓣舒张早期血流速度/二尖瓣舒张晚期血流速度）比值，左房内径、肺动脉内径、LVEDD（左心室舒张末期内径）较大，LVEF较低；而HF-PEF 患者的室间隔厚度较HF-REF患者的厚（P＜0.05）；（3）HF-PEF与HF-REF 患者相比较，患者的QRS 间期较短，易发生房性心律失常；而HF-REF 患者室性心律失常多见；差异均有统计学意义（P＜0.05）；（4）HF-PEF 患者与HF-REF患者相比，总胆固醇、甘油三酯、血肌酐、血尿素氮、血尿酸、超敏C反应蛋白和N-末端脑钠肽前体水平之间相比较，具有统计学差异，（P＜0.05）． 结论 HF-PEF 患者女性、工人等有职业人员所占比例较高；高龄患者较多；体重指数较大；血压水平较高．主要病因为高血压，房颤发生率高；以向心性肥厚为主，有明显的舒张功能不全，在心功能评价上，HF-PEF患者心功能Ⅱ级较多，易发生房性心律失常． |
| 关键词: ［关键词］射血分数保留的心力衰竭 临界HF-PEF 射血分数降低的心力衰竭 临床特征 |
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| The Clinical Characteristics of Patients with Chronic Heart Failure with Preserved Ejection Fraction |
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LI Yan-ping
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（Dept. of Cardiology，The 6th Affiliated Hospital of Kunming Medical University，People’s Hospital of Yuxi，Yuxi Yunnan 653100，China）
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| Abstract: |
| ［Abstract］Objective To investigate the difference in the clinical characteristics of patients with chronic heart failure with preserved ejection fraction（HF-PEF），HF-PEF，borderline andreduced ejection fraction （HF-REF）. Methods Two hundred and twenty-two patients with chronic heart failure in our hospital between August 2013 and August 2015 were analysed retrospectively. According to the different LVEF， the patients were divided into HF-PEF group（ n＝81），HF-PEF group，borderline group（n＝71） and HF-REF group（n＝70）. Each patient received examinations of echocardiography， electrocardiogram（ECG），blood biochemistry. And the clinical data of patients were recorded and the clinical characteristics of HF-PEF，HF-PEF，borderline and HF-REF were compared. Results （1）The difference was statistically significant between HF-PEF and HF-REF in patients with age， sex， occupation ratio，smoking history，body mass index（BMI），the basic cause of coronary heart disease， hypertension，atrial fibrillation and heart function classification，systolic blood pressure，and heart rate（P＜0.05）. （2）Compared with patients with HF-REF， E/A（mitral diastolic blood flow velocity / mitral diastolic blood flow velocity），left atrial diameter， pulmonary artery diameter，LVEDD（left ventricular end diastolic diameter） were larger，and LVEF was lower，while the HF-PEF patients had a thicker ventricular septum（P < 0.05）. （3）Compared with the patients with HF-REF， the QRS interval was shorter，Atrial arrhythmia was easy to occur in patients with HF-PEF，but ventricular arrhythmia in patients with HF-REF easy to occur（ P＜0.05）;（4） Compared with HF-REF patients， the levels of serum cholesterol，triglyceride，serum creatinine，blood urea nitrogen， blood urea nitrogen，serum uric acid，C reactive protein and N- terminal brain natriuretic peptide in patients with HF-PEF were statistically different（P＜0.05）. Conclusions In HF-PEF patients，the proportion of women，workers and so on is higher， the elderly patients are more， and the body mass index and blood pressure level is higher. Patients with history of hypertension have higher incidence of atrial fibrillation. HF-PEF patients with concentric hypertrophy have obvious diastolic dysfunction . The evaluation of cardiac function in patients with HF-PEF shows that the proportion of cardiac function grade II is higher and these patients are more prone to atrial arrhythmias. |
| Key words: ［Key words］Heart failure with preserved ejection fraction HF-PEF Borderline heart failure with reduced ejection fraction Clinical characteristics |