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超声对急性心力衰竭患者胃肠功能的评估价值

Evaluation value of ultrasound on gastrointestinal function in patients with acute heart failure.

作者信息

Hao Ruyi, Zheng Ye, Zhao Qing, Chen Jie, Fan Ruiqi, Chen Peng, Yin Na, Qin Huai

机构信息

Department of Diagnostic Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of Emergency, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Front Cardiovasc Med. 2024 Nov 25;11:1475920. doi: 10.3389/fcvm.2024.1475920. eCollection 2024.

Abstract

OBJECTIVE

To study the changes in gastrointestinal wall thickness, blood flow, motility, and symptoms in patients with acute heart failure, and to assess gastrointestinal function by ultrasound.

METHODS

In this study, patients diagnosed with acute heart failure were selected as the study group, and healthy individuals were selected as the control group. Both groups collected general data and completed the Chinese version of the gastrointestinal symptom rating scale. Ultrasonography was used to measure several abdominal vascular and gastrointestinal-related indicators. Statistical analysis used grouped comparison and correlation analysis.

RESULTS

The study group scored higher than the control group in total score, lower abdominal symptom score, constipation score, and difficult defecation score ( = -2.828, -2.022, -2.015, -2.015, all  < 0.05). The hepatic vein diameter, superior mesenteric vein inner diameter and wall thickness of the ascending colon in the study group were significantly higher than those in the control group ( = 9.543,  < 0.001;  = 2.277,  = 0.025;  = -2.062,  = 0.039). Antral contraction amplitude, antral contraction frequency, motility index, jejunal peristalsis frequency, and ascending colon peristalsis frequency were significantly lower in the study group compared to the control group ( = -2.571, -4.196, -3.681, -5.451, -4.061, all  < 0.001). The wall thickness of the antrum, jejunum, and ascending colon were positively correlated with the diameter of the hepatic vein ( = 0.394,  = 0.011;  = 0.352,  = 0.024;  = 0.450,  = 0.003). Motility index and ascending colon peristalsis frequency were positively correlated with the peak velocity of superior mesenteric vein ( = 0.456,  = 0.029;  = 0.507,  = 0.007). The wall thickness of the jejunum was positively correlated with the peak velocity of superior mesenteric artery ( = 0.330,  = 0.035). Peak velocity of superior mesenteric artery, antral contraction frequency, and jejunal peristalsis frequency were negatively correlated with the reflux score ( = -0.409,  = 0.038;  = -0.423,  = 0.032;  = -0.409,  = 0.038). The wall thickness of the ascending colon was positively correlated with the reflux score ( = 0.414,  = 0.035).

CONCLUSION

This study found that patients with acute heart failure exhibited thickening of the gastrointestinal wall and generally reduced gastrointestinal motility, with predominantly lower abdominal symptoms. These findings indicate that ultrasound can effectively monitor the gastrointestinal structure and function of patients with acute heart failure, which is expected to provide help for clinical diagnosis and treatment.

摘要

目的

研究急性心力衰竭患者胃肠道壁厚度、血流、蠕动及症状的变化,并通过超声评估胃肠道功能。

方法

本研究选取诊断为急性心力衰竭的患者作为研究组,选取健康个体作为对照组。两组均收集一般资料并完成中文版胃肠道症状评定量表。采用超声测量多项腹部血管及胃肠道相关指标。统计分析采用分组比较和相关性分析。

结果

研究组在总分、下腹部症状评分、便秘评分及排便困难评分上均高于对照组(= -2.828,-2.022,-2.015,-2.015,均<0.05)。研究组肝静脉直径、肠系膜上静脉内径及升结肠壁厚度均显著高于对照组(= 9.543,<0.001;= 2.277,= 0.025;= -2.062,= 0.039)。研究组胃窦收缩幅度、胃窦收缩频率、蠕动指数、空肠蠕动频率及升结肠蠕动频率均显著低于对照组(= -2.571,-4.196,-3.681,-5.451,-4.061,均<0.001)。胃窦、空肠及升结肠壁厚度与肝静脉直径呈正相关(= 0.394,= 0.011;= 0.352,= 0.024;= 0.450,= 0.003)。蠕动指数及升结肠蠕动频率与肠系膜上静脉峰值流速呈正相关(= 0.456,= 0.029;= 0.507,= 0.007)。空肠壁厚度与肠系膜上动脉峰值流速呈正相关(= 0.330,= 0.035)。肠系膜上动脉峰值流速、胃窦收缩频率及空肠蠕动频率与反流评分呈负相关(= -0.409,= 0.038;= -0.423,= 0.032;= -0.409,= 0.038)。升结肠壁厚度与反流评分呈正相关(= 0.414,= 0.035)。

结论

本研究发现急性心力衰竭患者存在胃肠道壁增厚且胃肠道蠕动普遍降低,以下腹部症状为主。这些发现表明超声可有效监测急性心力衰竭患者的胃肠道结构和功能,有望为临床诊断和治疗提供帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da85/11625756/9f84e6c4afe3/fcvm-11-1475920-g001.jpg

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