摘要
目的 通过比较急性左心衰竭(AHF)和充血性心力衰竭(CHF)时,患者肝功能检测指标的异同,为心力衰竭分型及进展提供诊断依据.方法 选取2014年3月~2015年12月浙江青田人民医院住院的心力衰竭患者142例,根据病情分为急性左心衰竭组68例和充血性心力衰竭组74例.通过入院后心力衰竭相关指标、肝脏血液生化学、一般生化指标的比较和后期随访资料收集,比较2组患者肝功能检测的差异.结果 心力衰竭相关指标比较:射血分数、氨基末端B型利钠肽原(NT-proBNP)无明显差异,心力衰竭病史>1年、合并右心衰竭患者数比较,差异有统计学意义(P<0.05).肝脏血液生化学比较:急性左心衰竭组患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)升高,差异有统计学意义(P<0.05),谷氨酰氨基转移酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)降低,差异有统计学意义(P<0.05).2组患者的碱性磷酸酶和总蛋白差异无统计学意义.一般生化指标比较,充血性心力衰竭组甘油三酯升高,差异有统计学意义(P<0.05),其余指标差异无统计学意义.结论AHF患者以ALT、AST升高为主,CHF以GGT、TBIL、DBIL、IBIL升高,ALB降低为主.
Abstract
Objective To compare the differences of liver function indexes in patients with acute left heart failure and congestive heart failure , and to provide the basis for the diagnosis of heart failure .Methods 142 cases of heart failure from March 2014 to December 2015 in our hospital were selected and divided into 68 cases of acute left heart failure group and 74 cases of congestive heart failure group.The differences in liver function tests were compared between the two groups by comparing the differences in the indexes of heart failure, liver blood biochemistry, general biochemical indexes and late follow-up data.Results Compared with the indexes of heart failure, there were no significant differences in ejection fraction, NT-proBNP, history of heart failure>one years, and the number of patients with right heart failure, the difference was statistically significant (P<0.05).Comparison of liver blood biochemistry: patients with acute left heart failure were alanine aminotransferase, aspartate amino transferase, albumin increased, the difference was statistically significant (P<0.05), and glutamyl aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin decreased, the difference was statistically significant (P<0.05).There was no significant difference between the two groups of patients with alkaline phosphatase and total protein.Compared with the general biochemical indexes, increased triglyceride levels in patients with congestive heart failure group, the difference was statistically significant (P<0.05), there was no significant difference in other indexes.Conclusion AHF patients with ALT, AST increased, CHF with GGT, TBIL, DBIL, IBIL increased, ALB decreased mainly.
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