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投稿时间：2019-08-27 网络发布日期：2020-04-20
投稿时间：2019-08-27 网络发布日期：2020-04-20
中文摘要: 目的 探讨心力衰竭超声指数在指导慢性心力衰竭患者超滤治疗时机选择中的应用及其价值。
方法 选择2015年12月至2016年12月滁州市第一人民医院住院并行超滤治疗的慢性心力衰竭患者31例的临床资料进行回顾性研究,依据超滤治疗后N-末端B型利钠肽原(NT-proBNP)降幅,将患者分为高效组(NT-proBNP降幅≥30%)和低效组(NT-proBNP降幅<30%)。绘制受试者工作曲线(ROC)确定心力衰竭超声指数在指导慢性心力衰竭患者最佳超滤治疗时机及其效能判断的最佳截断值选择。
结果 31例患者中高效组13例,低效组18例。高效组心力衰竭超声指数低于低效组（3.69±0.85 vs 5.83±1.29),超滤总时间、住院时间短于低效组,住院费用少于低效组,差异有统计学意义(P均<0.01)。两组患者超滤液体量比较无统计学差异(P>0.05)。以心力衰竭超声指数4.5为截断值时，其判断超滤时机的敏感度88.9％,特异度76.9％。
结论 心力衰竭超声指数或可作为慢性心力衰竭患者行“早期”超滤治疗的一种判断指标。
中文关键词: 慢性心力衰竭 心力衰竭超声指数 N-末端B型利钠肽原 超滤；治疗时机
Abstract:Objective To explore the application and value of heart failure echocardiography index(HFEI) in guiding the timing of ultrafiltration therapy for patients with chronic heart failure(CHF).
Methods A retrospective study was performed on 31 patients with CHF who were hospitalized with ultrafiltration treatment in the First People′s Hospital of Chuzhou from December 2015 to December 2016.Based on the range of discount in N-terminal B-type natriuretic peptide (NT-proBNP)after ultrafiltration treatment,patients were divided into a high-efficiency group (NT-proBNP reduction ≥30%) and a low-efficiency group (NT-proBNP reduction <30%).The receiver operating curve (ROC) was drawn to determine the best cut-off value of the HFEI in guiding the timing of ultrafiltration treatment in patients with CHF and its judgment efficiency.
Results Of the 31 patients,13 were in the high-efficiency group and 18 were in the low-efficiency group.The HFEI of the high-efficiency group was lower than that of the low-efficiency group(3.69±0.85 vs 5.83±1.29),the total time of ultrafiltration and hospital stay was shorter than those of the low-efficiency group,the hospitalization cost was less than that of the low-efficiency group,the difference was statistically significant (all P<0.01).There was no statistical difference in the rolume of ultrafiltration fluid between the two groups (P>0.05).When the HFEI was 4.5 as the cut-off value,the sensitivity for judging the timing of ultrafitration was 88.9% and the specificity was 76.9%.
ConclusionThe HFEI can be used as a judgment indicator for "early" ultrafiltration therapy for patients with CHF.
keywords: Chronic heart failure Heart failure echocardiography index N-terminal B-type natriuretic peptide Ultrafitration Timing of treatment
文章编号： 中图分类号： 文献标志码：A
基金项目:安徽省滁州市农社科研基金(201408)
引用文本：
赵继翠,黎敬锋,李银,等.心力衰竭超声指数在指导慢性心力衰竭患者超滤治疗时机中的价值[J].中国临床研究,2020,33(4):473-476.
赵继翠,黎敬锋,李银,等.心力衰竭超声指数在指导慢性心力衰竭患者超滤治疗时机中的价值[J].中国临床研究,2020,33(4):473-476.