肝硬化心功能障碍患病率及其与Meld评分的关系

Arvind Kumar, Tania Bansal, A. Bery, A. Sood
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引用次数: 0

摘要

背景:肝硬化患者有心脏结构和功能异常的报道。这些异常的组合被称为肝硬化心肌病(CCM),其患病率尚不清楚,主要是因为该疾病是潜伏的,当患者受到压力时才会显现出来。本研究旨在评估肝硬化患者心功能障碍的患病率,并分析其与终末期肝病模型(MELD)评分的关系。方法:选取100例肝硬化患者,按MELD评分≤9分、10-19分、≥20分分为3组。所有的研究参与者都用多普勒超声心动图进行了详细的心脏评估。测定心功能障碍的发生率及其与MELD评分的关系。结果:CCM和舒张功能障碍(DD)的患病率分别为48%和30%。共有82%、59%和50%的患者分别延长了校正QT间期(QTc)、等容松弛时间(IVRT)和减速时间(DT)。CCM、DD、延长QTc、IVRT、DT患病率与MELD评分有显著相关性(P < 0.05)。结论:肝硬化患者心功能受损,主要表现为CCM和DD,功能障碍程度与MELD评分相关。因此,MELD评分系统可用于预测肝硬化心功能障碍的发生风险。
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Prevalence of Cardiac Dysfunction in Cirrhosis and Its Relation With Meld Score
Background: Cardiac structural and functional abnormalities have been described in patients of liver cirrhosis. The constellation of these abnormalities is termed as cirrhotic cardiomyopathy (CCM) and its prevalence remains unknown, mostly because the disease is latent and shows itself when the patient is subjected to stress. This study was designed to evaluate the prevalence of cardiac dysfunction in patients of liver cirrhosis and to analyze its relation with model for end-stage liver disease (MELD) score. Methods: Hundred patients of liver cirrhosis were enrolled for the study and divided into 3 groups according to MELD score: ≤9, 10-19, and ≥20. All study participants underwent detailed cardiac assessment with Doppler echocardiography. Prevalence of cardiac dysfunction and its relation with MELD score was determined. Results: Prevalence of CCM and diastolic dysfunction (DD) was 48% and 30%, respectively. A total of 82%, 59%, and 50% patients had prolonged corrected QT interval (QTc), isovolumic relaxation time (IVRT), and deceleration time (DT), respectively. Prevalence of CCM, DD and prolonged QTc, IVRT, and DT had significant correlation with MELD score (P < .05). Conclusion: Patients with cirrhosis had impaired cardiac function, mainly present as CCM and DD, and the extent of dysfunction was correlated with the MELD score. Hence, MELD scoring system can be used to predict risk of occurrence of cardiac dysfunction in cirrhosis.
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期刊介绍: Indian Association of Clinical Medicine is an academic body constituted in the year 1992 by a group of clinicians with the main aim of reaffirming the importance of clinical medicine in this era of high-tech diagnostic modalities. There is no doubt that modern investigational methods have contributed a lot to the present day medical practice but that does not render clinical acumen and examination less important. The art and science of clinical medicine helps up to make proper and judicious use of investigations and not these be the sole basis of our practice. That is the basic idea behind this ''Association''. We presently have members and fellows of the association from all over the country. In August, 2002 the body was registered as "Indian Association of Clinical Medicine" by the Registrar of Societies, Delhi.
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