探讨特殊心脏病患者的心功能分级方案(1)
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[摘要] 目的：探讨特殊心脏病患者的心功能分级方案，以满足特殊心脏病患者心功能分级的需要。方法：选取心脏病患者83例，根据1928年纽约心脏病学会(NYHA)提出的心功能分级方案(简称NYHA方案)，将患者分为心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组，同时根据患者平卧时心悸、呼吸困难的情况及高枕卧位、半卧位或端坐位后症状的缓解情况，将患者的心功能分为1级、2级、3级、4级(简称特殊方案)，再将患者分为心功能1级组、2级组、3级组、4级组。然后，将心功能1级组与Ⅰ级组例数、2级组与Ⅱ级组例数、3级组与Ⅲ级组例数及4级组与Ⅳ级组例数分别进行比较。结果：两种分级方案中上述组与组之间例数比较均差异均无统计学意义(均P>0.05)。结论：心功能分级的特殊方案与NYHA方案具有等价性，可用于特殊心脏病患者的心功能分级。
[关键词] 特殊心脏病患者；心功能分级；NYHA方案；特殊方案
[中图分类号] R541 [文献标识码] A [文章编号] 1673-7210(2011)12(a)-055-03
Study of the scheme on heart function classification in special patients with heart disease
WANG Huilin, XIE Dengrong
Department of Cardiovasology, Huaihua General Hospital of the Second People's Hospital, Hu'nan Province, Huaihua 418000, China
[Abstract] Objective: To explore scheme on heart function classification in special patients with heart disease, so as to meet the need of this in these patients. Methods: 83 cardiopaths were selected. On the basis of the cardiac function scheme of New York Heart Association (NYHA scheme for short) in 1928, these patients were divided into NYHA classⅠgroup, Ⅱ group, Ⅲ group and Ⅳ group. At the same time, their heart function was graded, grade 1, 2, 3, 4, according to the status of cardiopalmus and dyspnea in horizontal position and the improvement of the above symptoms in laying patients' heads on their high pillows, semireclining position or orthopnea (special scheme for short). Then these patients were also separate into cardiac grade 1 group, 2 group, 3 group and 4 group. And then the numbers of heart function grade 1 group and Ⅰ group, 2 group and Ⅱ group, 3 group and Ⅲ group, 4 group and Ⅳ group were respectively compared. Results: There were all no statistical differences in the above compared numbers between groups(P>0.05). Conclusion: The special scheme to grade heart function is equal to NYHA. And the special scheme can be used in heart function classification of special cardiac patients.
[Key words] Special patients with heart disease; Heart function classification; NYHA scheme; Special scheme
心功能的分级方案有多种，但几十年来，NYHA方案使用最广[1]，这种方案是按诱发心力衰竭症状的活动程度将心功能的受损状况进行分级[2]，因此，如果由于心脏病外的其他原因(如慢性阻塞性肺疾病、下肢瘫痪、严重贫血、严重营养不良、下肢关节炎、下肢外伤、严重衰老等)影响患者的自主活动时，该方案则难以对这些患者(特殊心脏病患者)的心功能进行准确分级，因此，笔者考虑是否有其他可回避这些问题的分级方案，以便对这些特殊心脏病患者的心功能进行分级。经过仔细的临床观察，笔者发现可根据患者平卧时心悸、呼吸困难的情况及高枕卧位、半卧位或端坐位后症状的缓解情况进行分级 ......
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