超声心动图对充血性心力衰竭患者中医辨证分型及左心室功能的诊断价值

目的:使用超声心动图探讨充血性心力衰竭(CHF)不同中医辨证分型与左心室功能不全的关系。方法:以95例CHF患者为观察组,以同期就诊的23例非CHF患者为对照组,将观察组分为单纯心气虚证27例,兼血瘀证40例,兼阴虚证17例,兼气虚血瘀证11例,停用影响血管紧张素系统(RAAS)的药物与洋地黄类药物1周。2组均采用彩色多普勒超声心动图仪测定左心室射血分数(LVEF)及二尖瓣口A峰/E峰(A/E)结果:CHF患者LVEF降低,A/E组增高,与对照组比较,差异有统计学意义(P0.05)。CHF患者4种中医证型与LVEF呈负相关(r=-0.27,P0.05),与A/E呈显著正相关(r=0.524,P0.05)。结论:A/E比值、LVEF可以作为CHF中医辩证分型的定量指标之一。

The Value of Echocardiography in Diagnosing TCM Syndrome Differentiation and Left Ventricular Function Diagnosis of Congestive Heart Failure Patients

Objective:To study the relationship between different TCM syndrome differentiation of congestive heart failure (CHF) and left ventricular dysfunction by echocardiography.Methods:All 95 CHF patients were chosen as the observation group,and 23 non-CHF patients visited at the same time were taken as the control group.95 patients in the observation group were divided as simple heart qi deficiency syndrome (27 cases),heart Qi deficiency with blood stasis syndrome (40 cases),heart Qi deficiency with Yin deficiency syndrome (17 cases) and heart Qi deficiency with blood stasis syndrome (11 cases).And the drugs that will affect renin-angiotensin system (RAAS) and digitalis glycosides were stopped to use for a week.Left ventricular ejection fiaction (LVEF) and mitral valve A peak/E peak (A/E) were measured by echocardiography.Results:LVEF decreased and A/E increased of CHF patients,compared with the control group,the difference was statistically significant (P ＜0.05).Four TCM syndromes of the CHA patients were negatively correlated with LVEF (r=-0.27,P＜0.05),and positively correlated with A/E (r=0.524,P＜0.05).Conclusion:A/E ratio and LVEF can be taken as one of the quantitative indicators for the TCM syndrome differentiation in CHF.