高血压性左心室肥厚及射血分数保留的心力衰竭(HF-PEF)患者左心室同步性变化对心功能的影响

目的:探讨高血压性左心室肥厚及射血分数保留的心力衰竭(HF-PEF)患者左心室同步性变化状况及其对心功能的影响。方法:对某院2016年5月~2018年5月收治的110例高血压性左心室肥厚(左心室肥厚组)患者、110例高血压性HF-PEF(HF-PEF组)患者进行观察研究,对所有患者均进行心脏超声检查、血清B型尿钠肽(BNP)检查,分析总结不同患者检测结果。结果:HF-PEF组患者LVEF与左心室肥厚组对比无明显差异(P>0.05);HF-PEF组患者E/A值、PFR明显低于左心室肥厚组,LVEDD、LAD、BNP明显高于左心室肥厚组(P<0.05);HF-PEF组BNP与E/A值、PFR呈负相关性(P<0.05);HF-PEF组BNP与LVEDD、LAD呈正相关性(P<0.05)。结论:高血压性HF-PEF患者左心室呈现明显同步性异常,且与患者心功能存在相关性。     

Change of Hs-CRP level and its clinical features in elderly patients with metabolic syndrome

Background Elevated serum Hs-CRP level may be an independent predictor of metabolic syndrome(MS)in healthy individuals. Many elderly patients have metabolic syndrome. Therefore,we observed the clinical features of serum Hs-CRP level in elderly patients with metabolic syndrome to further understand the relationship between the two. Methods A total of 210 patients were divided into two groups:metabolic syndrome(MS,n=1112)group and non-metabolic syndrome(Non-MS,n=98)group. The serum Hs-CRP level was tested by immunoturbidimetry and the clinical features of Hs-CRP were analyzed. The associations of Hs-CRP with BMI,WHR,FBG,TG,TC,LDL-C,HDL-C,SBP,DBP and Homa-IR were determined. Results Serum HsCRP level was significantly higher in the MS group than in the non-MS group(P0.05). Besides,with the increase in the number of included factors,the level of Hs-CRP gradually increased significantly(P0.05).Moreover,serum Hs-CRP was positively correlated with age,BMI,WHR,SBP,DBP,FPG,FIN,TG,TC,Homa-IR(r=0.38,0.49,0.33,0.36,0.31,0.34,0.43,0.37,0.18,0.34,respectively,P0.05)and negatively correlated with HDL-C(r=-0.37,P0.001). Conclusion Serum Hs-CRP level is associated with many factors. It is a proactively marker for cardiovascular disease risk assessment of elderly MS patients.[S Chin J Cardiol 2019;20(3):156-162]     

PCI术后Ⅰ期心脏康复患者不同时间行6分钟步行试验的安全性比较

目的探讨急性心肌梗死PCI术后Ⅰ期心脏康复患者提前行6分钟步行试验的安全性及可行性。方法将69例急性心肌梗死PCI术后Ⅰ期心脏康复患者随机分为对照组34例和观察组35例。对照组于出院前1 d行6分钟步行试验,观察组于PCI术后第4天行6MWT。比较两组6分钟步行距离及试验中的心率、血压、血氧饱和度、BORG评分和心律失常发生情况。结果两组均完成6分钟步行试验,两组6分钟步行距离及试验中的心率、血压、血氧饱和度、BORG评分、心律失常发生率无显著差异(均P0.05)。结论急性心肌梗死PCI术后Ⅰ期心脏康复患者将6分钟步行试验提前至术后第4天进行安全可行,可以评价Ⅰ期心脏康复的效果和运动能力,使患者出院前能更好得掌握自我训练方法,从而提高运动耐力。