冠心病心衰中医证型与心功能分级、LVEF、CO、CI及BNP的相关性分析

目的探讨冠心病所致慢性心力衰竭(CHF)患者中医证型与心功能分级、脑钠肽(BNP)及心脏超声指标(LVEF、CO、CI)的关系,为冠心病心力衰竭临床辨证提供参考指标。方法选择冠心病住院患者154例,按NYHA分级标准进行心功能分级,中医辨证分为心气阴虚证、心气阳虚证、气虚血瘀证、阳虚水泛证、心阳虚脱证5型,检测BNP、超声心动图指标(LVEF、CO、CI)。结果各中医证型组中,LVEF、CO、CI从心气阴虚、心气阳虚、气虚血瘀、阳虚水泛、心阳虚脱呈依次降低趋势,BNP呈依次增高趋势,组间比较,差异有统计学意义(P<0.05或P<0.01);心功能分级阶次升高。结论 LVEF、CO、CI、BNP均可间接反应冠心病心力衰竭患者的患病程度及预后,中医辨证分型与心功能分级密切相关,各项参考指标可为中医辨证分型提供客观量化依据。

Relation between TCM Syndrome of Coronary Heart Disease Related Heart Failure and Function Class, LVEF, CO, CI and BNP

Objective To investigate the relationship between TCM syndrome of coronary heart disease related heart failure and function class, LVEF, CO, CI and BNP, provide reference indication for coronary heart disease related heart failure. Methods BNP, LVEF, CO, CI of 154 patients with coronary heart disease were examined and the patients were divide into five TCM syndrome type. To detect BNP, hyperacoustie dynamic indications （LVEF, CO, CI）Results BNP, LVEF, CO and CI were significantly different between different TCM syndrome type. BNP is inclined to increase successively, and the difference should apply to statistics （ P 〈 0. 05 or P 〈 0. 01 ） ; heart function increase as classes. Conclusion TCM syndrome of coronary heart disease related heart failure is related to heart function and the function parameter could be served as quantitative evidence for TCM syndrome.