肝硬化患者心功能改变及相关因素分析

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1、万方数据温州医科大学硕士学位论文与child分级不呈等级相关1．3BNP与ALB呈负相关(F．0．238，p=0．037)1．4超声心动图检查肝硬化组内BNP水平与左室射血分数显著呈显著相关(r=-0．269，p=0．041)1．5BNP与贫血程度、Em／Am比值、及QTCB无相关性。2．肝硬化心脏超声检查2．1LVEF与贫血程度及血浆BNP显著相关，分别为(F．0．362，p=0．005；r=一0．291，p=0．027)2．2大量腹水忠者Em／Am水平较无或少量腹水低，差别有统计学意义(r=一0．278j

2、P=0．034)，与BNP、Alb、QTCB、child分级等均无相关关系2．3有70．7％的肝硬化患者Em／Am

3、且与肝脏储备功能存在相关性。而心脏超声检查及心电图简便易行，可以较好的反应心脏的收缩、舒张功能，电生理异常，应当作为肝硬化(特别是择期行TIPS术或肝移植手术)患者临床评估的重要检查手段。【关键词】：肝硬化；肝硬化性心肌病；QT间期延长；B型脑利钠肽万方数据温州医科大学硕士学位论文StudyofCardiacDysfunctioninCirrhoticPatientsandCorrelationFactorsAnalysisAbstractObjective：Cirrhoticcardiomyopathyis

4、acardiacconditionobservedinpatientswithcirrhoticregardlessoftheetiologies．Itischaracterizedbytheimpairedsystolicresponsetophy’sicalstress，diastolicdysfunction，andelectrophysiologicalabnormalities．Itspathophysiologyandclinicalsignificancehasbeenafocusofvario

5、usresearchersforthepastdecades．TheincreasedrecognitionofthisdiseasewillpreventthecomplicationsofovertheartfailureafterproceduressuchasTransjugularIntrahepaticPortosystemicShunt(TIPS)andLiverTransplantation(LT)．Theimpairmentof[3-adrenergicreceptogthepresence

6、ofcardiosuppressantssuchasnitricoxideandinflammatorycytokinesaretheproposedmechanismsofsystolicdysfunction．TheactivationofRASSandsaltretentionplaytheroleinthedevelopmentofcardiacimpairment．Theincreasedrecognitionofthisdiseasewillpreventthecomplicationsofove

7、rtheartfailureafterproceduressuchasTIPSandLT．Betterunderstandingofcirrhoticcardiomyopathyiscrucial．ThisstudyisdesignedtoprovidesageneraloverviewofCCMbyperformingEchocardiographyandelectrocardiographicexaminationation，andblooddetective，analyzingitscorrelatio

8、nwithliverreservefunction，ailemiaandotherclinicaldataanddiscussingthepossibleetiologyandpathogenesis．Methods：77in—patients(57maleand20femal，meanage57years)．fromJuly2013toApril2014wereincludedinthisstud