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编号:13204175
24 h动态心电图和超声特征对慢性左心衰治疗疗效评价及预后预测价值研究(1)
http://www.100md.com 2018年1月5日 中国医学创新 2018年第1期
     【摘要】 目的:觀察24 h动态心电图和超声特征对慢性左心衰治疗效果与预后的评估价值。方法:选取本院在2014年3月-2016年6月收治的69例慢性左心衰患者,接受按照2009年AHA心力衰竭治疗指南制定的常规临床治疗,随访1年,分别于随访前后进行24 h动态心电图、超声心动图检查,按HF-EMPS评分法对患者进行心脏功能评价,若HF-EMPS评分升高≥1分,则认为左心衰竭功能改善,设为预后良好组(n=39);若HF-EMPS评分未提高,甚至降低,设为预后不良组(n=30),比较两组患者治疗前后24 h动态心电图和超声心动图检查结果。结果:随访开始时两组患者24 h动态心电图、超声心动图检查结果比较差异均无统计学意义(P>0.05)。随访1年后,预后良好组LVDD、LVEF、CI指标明显优于预后不良组,比较差异均有统计学意义(P<0.05);预后良好组频发室早、房颤、频发房早、ST-T改变例数明显少于预后不良组,比较差异均有统计学意义(P<0.05)。结论:24 h动态心电图和超声心动图检查可以较好地评价慢性左心衰的治疗效果,对患者预后具有较高的预测价值。
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    【关键词】 24 h动态心电图; 超声特征; 慢性左心衰; 评估价值

    Evaluation the Clinical Effect of 24 Hours Ambulatory ECG and Ultrasonic Characteristics in Treatment of Chronic Left Heart Failure and Research of Prognostic Value/YANG Hengqin.//Medical Innovation of China,2018,15(01):014-017

    【Abstract】 Objective:To observe the evaluation value of treatment effect and prognosis of 24 h dynamic electrocardiogram and ultrasonic characteristics for chronic left heart failure.Method:69 patients with chronic left heart failure and who treated in our hospital from March 2014 to June 2016 were selected,they were prescribed the general treatment and medication according to the 2009 AHA heart failure treatment guidelines.Then,the patients were followed up for 1 year,24 h dynamic electrocardiogram and echocardiogram were performed before and after the follow-up respectively,and the cardiac function of patients were evaluated according to the HF-EMPS scoring method.If the HF-EMPS score increased greater than or equal to 1 point,that left heart failure function improvement,defined as good prognosis group(n=39).If the HF-EMPS score was not improved,the even lowered was defined as a poor prognosis group(n=30).Then,the results of 24 h dynamic electrocardiogram and echocardiography were compared between the two groups of patients before and after the treatment.Result:At the beginning of the follow-up,there was no significant difference in 24 h dynamic electrocardiogram and echocardiogram between the two groups(P>0.05).After 1 year of follow-up,the levels of LVDD,LVEF and CI in the good prognosis group were better than those in the poor prognosis group,the differences were statistically significant (P<0.05).The frequent ventricular fibrillation,atrial fibrillation,and frequent atrial fibrillation,the number of cases of ST-T change in the good prognosis group were better than that in the poor prognosis group,and the difference was statistically significant(P<0.05).Conclusion:The 24 h dynamic electrocardiogram and echocardiogram examination can better evaluate the therapeutic effect of chronic left heart failure,thus it has high predictive value for prognosis., 百拇医药(杨珩钦)
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