本文選題：心肌病　切入點(diǎn)：肥厚性　出處：《中國(guó)循環(huán)雜志》2017年01期 　論文類(lèi)型：期刊論文

【摘要】：目的:探討血漿大內(nèi)皮素-1(Big ET-1)水平與肥厚型梗阻性心肌病(HOCM)患者心臟重構(gòu)的相關(guān)性。方法:入選自2015-01至2016-05于我院住院治療的HOCM患者167例,測(cè)定血漿Big ET-1、N末端B型利鈉肽原(NT-pro BNP)水平等指標(biāo),完善心電圖、動(dòng)態(tài)心電圖、超聲心動(dòng)圖(UCG)及心臟磁共振成像(CMR)檢查,進(jìn)行相關(guān)統(tǒng)計(jì)學(xué)分析。結(jié)果:在167例HOCM患者中,相關(guān)性分析及多元線性回歸發(fā)現(xiàn)Ln Big ET-1與Ln NT-pro BNP(r=0.35,P=0.000)、左心房前后徑(r=0.169,P=0.019)及心率(r=0.141,P=0.037)呈正相關(guān),與血紅蛋白(r=-0.173,P=0.013)及室間隔厚度/左心室后壁厚度比值(r=-0.165,P=0.017)呈負(fù)相關(guān)�；贐ig ET-1與左心房前后徑呈正相關(guān)的發(fā)現(xiàn),將研究對(duì)象分為左心房正常組74例及左心房增大組93例。與左心房正常組比,左心房增大組患者血漿Big ET-1水平顯著增高(P=0.001);UCG測(cè)量的左心室舒張末期內(nèi)徑較大(P=0.024),室間隔較厚(P=0.003),左心室射血分?jǐn)?shù)偏低(P=0.001);CMR測(cè)量的左心室舒張末期容積(P=0.002)及室間隔厚度(P=0.002)較大;伴發(fā)心房顫動(dòng)的比率增加(P=0.004);存在二尖瓣中-大量反流(P=0.011)及紐約心臟協(xié)會(huì)(NYHA)心功能Ⅲ或Ⅳ級(jí)(P=0.022)的患者增多。結(jié)論:在HOCM患者中,Ln Big ET-1與Ln NT-pro BNP、左心房?jī)?nèi)徑呈正相關(guān)。左心房增大的HOCM患者血漿Big ET-1水平顯著升高,心臟結(jié)構(gòu)重構(gòu)更明顯,伴發(fā)心房顫動(dòng)的比率增加。Big ET-1可能在HOCM患者的心臟重構(gòu)中發(fā)揮作用。
[Abstract]:Objective: to investigate the relationship between the level of plasma large endothelin-1 big ET-1 and cardiac remodeling in patients with hypertrophic obstructive cardiomyopathy (HCM). Methods: 167 HOCM patients who were hospitalized in our hospital from January 2015 to June 2005 were enrolled in this study. Plasma levels of plasma Big ET-1 N-terminal natriuretic peptide (NT-pro) were measured, electrocardiogram (ECG), dynamic electrocardiogram (ECG), echocardiography (UCG) and cardiac magnetic resonance imaging (Big) were examined. Correlation analysis and multivariate linear regression showed that there was a positive correlation between Ln Big ET-1 and Ln NT-pro BNPR 0.35, left atrium anterior and posterior diameter 0.169 Pu 0.019) and heart rate mensurus 0.141% P0. 037). There was a negative correlation between the ratio of interventricular septal thickness to left ventricular posterior wall thickness and the ratio of interventricular septal thickness to left ventricular posterior wall thickness, based on the positive correlation between Big ET-1 and the anterior and posterior diameter of left atrium. The subjects were divided into left atrial normal group (74 cases) and left atrial enlargement group (93 cases). The plasma Big ET-1 level in patients with left atrial enlargement was significantly higher than that in patients with left atrial enlargement. The left ventricular end-diastolic diameter was larger, the ventricular septum was thicker, the ventricular septum was thicker, the left ventricular ejection fraction was lower (P 0.001) and the left ventricular end-diastolic volume (P 0.002) and the interventricular septal thickness (P 0.002) were larger. The incidence of atrial fibrillation was increased in patients with moderate mitral mitral regurgitation (P0.011) and NYHA 鈪，

本文編號(hào)：1590166