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目的:评价肝病患者肝病严重程度与左心功能的关系.方法:研究对象来自我院行原位肝移植的94例肝硬化患者.回顾性分析所有患者的生化指标、心脏超声、心电图和凝血指标等资料.根据终末期肝病模型(the model for end-stage liver disease,MELD)评分系统评价患者的肝病严重程度,将其分为3组:轻度组(34例,MELD评分≤9分)、中度组(44例,10分≤MELD评分≤19分)、重度组(16例,MELD评分≥20分).采用单因素方差分析、相关性分析等评价肝病严重程度与心功能之间的关系.结果:三组患者的肌酐、总胆红素以及国际标准化比值比较差异均有统计学意义(P<0.05),且肝病严重程度与肌酐、总胆红素以及国际标准化比值均呈正相关(分别为r=0.594,P=0.000;r=0.763,P=0.000;r=0.653P=0.000).随着肝病严重程度的增加,左房内径(left atrial diameter,LAD)、室间隔厚度(interventricular septum thickness,IVST)、左室舒张末期内径(left ventricular end-diastolicdiameter,LVEDD)、主动脉瓣流速(aortic valveflow,AF)、QT间期(corrected QT interval,QTc和心输出量(cardiac output,CO)的均数都逐渐增加,并且组间差异具有统计学意义(P<0.05).结论:MELD评分系统可以有效地反应肝病严重程度,且随着终末期肝病的进展,心脏的结构,功能及电生理活动逐渐减退.
Objective: To evaluate the relationship between the severity of liver disease and left ventricular function in patients with liver disease.Methods: The subjects were from 94 patients with liver cirrhosis who underwent orthotopic liver transplantation in our hospital.Results The biochemical, echocardiographic, and coagulation parameters of all patients were retrospectively analyzed , Etc. According to the model of end-stage liver disease (MELD), the severity of liver disease was evaluated and divided into three groups: mild group (34 cases, MELD score ≤9) (44 cases, 10 points ≤ MELD score ≤ 19 points), severe group (16 cases, MELD score ≥ 20 points) .Use one-way ANOVA and correlation analysis to evaluate the relationship between the severity of liver disease and cardiac function Results: The creatinine, total bilirubin and the international standardization ratio of the three groups were significantly different (P <0.05), and the severity of liver disease was positively correlated with creatinine, total bilirubin and the international standardization ratio R = 0.763, P = 0.000; r = 0.653P = 0.000) .With the increase of severity of liver disease, left atrial diameter (LAD), interventricular thickness septum thickness, IVST), left ventricular end-diastolic (LVEDD), aortic valve flow (AF), corrected QT interval (QTc) and cardiac output (CO) were all increased gradually, (P <0.05) .Conclusion: MELD scoring system can effectively reflect the severity of liver disease, and with the progress of end-stage liver disease, the structure, function and electrophysiological activity of heart gradually diminish.