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目的 比较肺部超声在不同心衰类型中应用的差异，并分析肺部超声与其他指标的相关性。方法 124例急性患者，射血分数(EF)保留型(HF)组（HFpEF）48例；EF减低型HF组(HFrEF)76例。比较2组间临床资料以及心肺超声指标的差异，并进一步分析肺水B线在两种HF类型中分别与氨基末端脑钠尿肽原（NT-proBNP）、E/e’和左室EF（LVEF）的相关性的差异。结果 HFpEF组和HFrEF组两组患者在基本临床资料方面均无明显统计学差异；HFpEF组的LVEF、室间隔厚度明显高于HFrEF组，而左室舒张末期内径、左室收缩末期内径、下腔静脉直径均明显小于HFrEF组。两组患者的左房前后径、E/A、肺动脉压（PAP）、E/e’和B线均无明显统计学差异。在HFpEF组中B线与E/e’的相关性优于NT-proBNP（r=0.886,r=0.755）,而在 HFrEF组中肺水B线与NT-proBNP的相关性优于E/e’（r=0.829,r=0.737）。结论 无论HFpEF，还是HFrEF，B线与NT-proBNP、E/e’均有良好的正相关性。
Objective To compare the differences in the application of pulmonary ultrasound in different types of heart failure and to analyze the correlation between pulmonary ultrasound and other indicators. Methods A total of 124 patients with acute exacerbation were enrolled in this study. Forty-eight patients with HF-EF (HF) and 76 patients with EF-reduced HF (HFrEF) were enrolled in this study. The differences of clinical data and cardio-pulmonary ultrasonographic parameters between the two groups were compared and the correlation between the B-line of lung water and the levels of NT-proBNP, E / e ’and left ventricular EF LVEF). Results There was no significant difference in basic clinical data between HFpEF group and HFrEF group. The LVEF and interventricular septum thickness in HFpEF group were significantly higher than those in HFrEF group, while the left ventricular end-diastolic dimension, left ventricular end-systolic diameter, Vein diameter were significantly smaller than the HFrEF group. Left atrium anteroposterior diameter, E / A, pulmonary arterial pressure (PAP), E / e ’and B were not significantly different between the two groups. The correlation between B line and E / e ’in HFpEF group was better than that of NT-proBNP (r = 0.886, r = 0.755), while correlation between B line and NT-proBNP in HFrEF group was superior to E / e ’(R = 0.829, r = 0.737). Conclusions Both HFpEF and HFrEF, B line had a good positive correlation with NT-proBNP and E / e ’.