CAJ | 학술논문

目的：探讨慢性心力衰竭患者左心房结构及功能与近期心血管不良事件的关系。方法入选慢性心力衰竭患者92例，治疗随访3个月，彩色多普勒超声检查左心房结构及功能变化，观察各种原因死亡、心力衰竭再加重住院的发生率，另设健康对照组30例，进行观察比较。结果心力衰竭患者92例中，失访6例，事件组23例，非事件组63例。（1）左心房结构变化：与健康对照组比较，心力衰竭组患者左心房最大容积（LAVmax）、P容积（LAVp）及最小容积（LAVmin）等各结构指标均扩大（ P ＜0沣．01）；与非事件组患者比较，事件组左心房各结构指标均进一步扩大（ P ＜0．05）。（2）左心房功能变化：与健康对照组比较，心力衰竭组患者的左心房存储容积（LARV）、左心房主动排空容积（LASV）、左心房主动排空分数（LAAEF）有不同程度的升高（ P ＜0．01），而左心房管道容积（LACV）则减低（P＜0．01）；与非事件组患者比较，事件组 LAAEF、LACV 均减低（ P ＜0．05），而 LASV、LARV 无显著变化（ P ＞0．05）。结论超声检测左心房结构及功能指标是预测慢性心力衰竭患者近期心血管不良事件的较好指标。
목적：탐토만성심력쇠갈환자좌심방결구급공능여근기심혈관불량사건적관계。방법입선만성심력쇠갈환자92례，치료수방3개월，채색다보륵초성검사좌심방결구급공능변화，관찰각충원인사망、심력쇠갈재가중주원적발생솔，령설건강대조조30례，진행관찰비교。결과심력쇠갈환자92례중，실방6례，사건조23례，비사건조63례。（1）좌심방결구변화：여건강대조조비교，심력쇠갈조환자좌심방최대용적（LAVmax）、P용적（LAVp）급최소용적（LAVmin）등각결구지표균확대（ P ＜0풍．01）；여비사건조환자비교，사건조좌심방각결구지표균진일보확대（ P ＜0．05）。（2）좌심방공능변화：여건강대조조비교，심력쇠갈조환자적좌심방존저용적（LARV）、좌심방주동배공용적（LASV）、좌심방주동배공분수（LAAEF）유불동정도적승고（ P ＜0．01），이좌심방관도용적（LACV）칙감저（P＜0．01）；여비사건조환자비교，사건조 LAAEF、LACV 균감저（ P ＜0．05），이 LASV、LARV 무현저변화（ P ＞0．05）。결론초성검측좌심방결구급공능지표시예측만성심력쇠갈환자근기심혈관불량사건적교호지표。
Objective To observe the relationship between chronic heart failure patients with left atrial structure and function and the recent adverse cardiovascular events .Methods Ninty-two patients of chronic heart failure were enrolled , all patients were followed up for 3 months, changes of left atrial structure and function were detected by ultrasound , death from all causes, and then aggravate of heart failure and the incidence of hospitalization were recorded , another 30 healthy as control group, they were observed and compared .Results In 92 cases of patients with heart failure , 6 cases were lost of follow-up, event group were 23 cases, non-event group of 63 cases.(1) Left atrial structural change: compared with health control group, the left atrium in patients with congestive heart failure (LAVmax), P volume (LAVP), the minimum volume (LAVmin) and other structural indicators are expanding ( P <0.01);compared with the non-event group, event group's indexes of left ventricular structure were further expanded ( P <0.05).(2) The changes of left atrial function:compared with health con-trol group, left atrial volume storage (LARV), left atrial emptying volume (LASV), left atrial emptying fraction (LAAEF) in patients with heart failure were increased in different degrees ( P <0.01), and left atrial conduit volume (LACV) were de-creased ( P <0.01);compared with the non-event group, LAAEF, LACV were decreased in the event group ( P <0.05), while LASV, LARV had no significant change ( P >0.05).Conclusion Ultrasonic detection of left atrial structure and function in patients with chronic heart failure is a better predictor of recent adverse cardiovascular events .