摘要目的 探究新一代心音图技术在心力衰竭诊断中的相关参数与脑利钠肽(BNP)、左室射血分数(LVEF)及心功能分级的相关性.方法 选取海口市人民医院心内科2016年5月至2017年7月期间住院病人168例为心功能不全组(心功能Ⅰ级组29例,心功能Ⅱ级40例,心功能Ⅲ级64例,心功能Ⅳ级35组),选取体检心功能正常者87例为健康组,分别行心音图检查、BNP测定、LVEF检查,进行数据分析.结果 QRS间期、EMAT％、EMAT、SDI、S3等指标在心功能不同分级中组间差异具有统计学意义(P＜0.05);LVST在心功能Ⅰ级与正常组中差异无统计学意义(P＞0.05),其他分组间差异具有统计学意义;QRS间期、EMAT％、SDI、S3与BNP之间存在正相关性(t值分别为9.46、11.38、12.14、9.67,P＜ 0.05),LVST与BNP存在负相关性(t值-14.27,P＜ 0.05);QRS间期、EMAT％、SDI、S3与LVEF之间存在负相关性(t值分别为11.24、-8.764、-2.393、-0.579,P＜0.05),LVST与LVEF之间存在正相关性(t值23.48,P＜0.05);QRS间期、EMAT％、SDI、S3与心功能分级之间存在正相关性(β分别为0.003、0.234、0.419、0.352,P＜0.05),LVST与心功能分级存在负相关性(β-0.021,P＜0.05).结论 心音图参数EMAT％、EMAT、SDI、S3与BNP、LVEF、心功能分级存在密切相关性,可作为心力衰竭患者诊断和评估的辅助指标.

abstractsObjective To explore the correlation between the parameters of the new generation of Acoustic Cardiography and brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF) and cardiac function grading in the diagnosis of heart failure.Methods One hundred and sixty-eight inpatients,who were hospitalized in Department of Cardiology,Haikou People's Hospital from May 2016 to July 2017,were enrolled as heart failure group,including NYHA class Ⅰ (n =29),NYHA class Ⅱ (n =40),NYHA class Ⅲ (n =64),NYHA class ⅣV (n =35).And eighty-seven patients with normal cardiac function were selected as healthy control group.The data of the two groups were analyzed after the Acoustic Cardiography test,BNP determination and LVEF examination.Results The differences in QRS duration,electromechanical activation time (EMAT),EMAT％,systolic dysfunction index (SDI),third heart sound (S3) and other indicators among the groups with different levels of cardiac function were statistically significant (P ＜ 0.05).The difference in left ventricular systolic time (LVST) between the cardiac function grade Ⅰ and healthy group was not significant (P ＞ 0.05),while the differences among the rest groups were significant.There was a positive correlation between QRS duration,EMAT％,SDI,S3 and BNP (t =9.46,11.38,12.14,9.67,respectively,P ＜ 0.05);LVST and BNP were negatively correlated (t =-14.27,P ＜ 0.05).There was a negative correlation between QRS duration,EMAT％,SDI,S3 and LVEF (t =11.24,-8.764,-2.393,-0.579,respectively,P ＜ 0.05).There was a positive correlation between LVST and LVEF (t =23.48,P ＜ 0.05).There was a positive correlation between QRS duration,EMAT％,SDI,S3 and cardiac function grading (β =0.003,0.234,0.419,0.352,respectively,P ＜ 0.05).There was a negative correlation between LVST and cardiac function grade (3 =-0.021,P ＜ 0.05).Conclusion The parameters of the Acoustic Cardiography test (EMAT％,EMAT,SDI,S3) are closely related to BNP,LVEF and cardiac function grading,and can be used as assistant indexes for the diagnosis and evaluation of heart failure.