The Retrospective Analysis Of Alcoholic Cirrhosis On Left Ventricular Form And Systolic Function

Objective:By the research and analysis left ventricular diameter (LVD),ejection fraction (EF) of alcoholic cirrhosis,hepatitis B cirrhosis (HBC)and healthy controls using ultrasonic cardiogram to find if they have statistically difference, discussing whether the myocardial disease has a difference between AC and HBC, to provide evidence for clinical diagnosis and treatment of different cirrhotic cardiomyopathy (CCM).Methods:We collected the patients with cirrhosis at one and two unit of digestive system department from August 2012 to August 2014 in the second affiliated hospital of Kunming Medical University,in all of those 210 patients with AC and 215 patients with HBC were selected as case groups; and 100 healthy men from medical examination center of the second affiliated hospital of Kunming Medical University were selected as a control group. Record the gender, age, weight, height, LVD and EF, and collected the degree of hepatic encephalopathy(HE),ascites, albumin(ALB), prothrombin time (PT).total bilirubin (TBIL) in case groups for grading their Child-Pugh class. At last, analysing if there have statistically differences in LVD and EF of patients with AC, patients with HBC and healthy controls.Results:1. The comparison of LVD from patients with AC, patients with HBC and healthy controls.1.1 Horizontal analysis1.1.1 The LVD of patients with AC Child-Pugh B, C class (48.83±1.07mm、 52.02±2.03mm) is respectively larger than control group (46.43±1.34mm), the difference is statistically significant (P<0.01,respectively). The LVD of patients with alcoholic cirrhosis Child - Pugh A class (48.00±0.00mm) compares with control group (46.43± 1.34mm), the difference is not statistically significant.1.1.2 The LVD of patients with HBC Child - Pugh B, C class (48.49± 1.63mm, 50.56±1.97mm) is respectively larger than control group (46.43±1.34mm), the difference is statistically significant (P<0.01, respectively). The LVD of patients with HBC Child - Pugh A class (47.25±1.24mm) compares with control group (46.43± 1.34mm), the difference is not statistically significant (P> 0.05).1.1.3 The LVD of patients with AC Child - Pugh B, C class (48.83±1.07mm、 52.02±2.03mm) is respectively larger than patients with HBC Child - Pugh B, C class (48.49±1.63mm、50.56±1.97mm), the difference is statistically significant (P＜0.01,respectively).The LVD of patients with alcoholic cirrhosis Child - Pugh A class(48.00±0.00mm)compares with HBC Child - Pugh A class(47.25±1.24mm), the difference is not statistically significant (P> 0.05).1.2 Vertical analysis1.2.1 The LVD of patients with AC Child - Pugh C class (52.02±2.03mm) is respectively larger than patients with AC Child - Pugh B class (48.83±1.07mm), Child - Pugh A class (48.00±0.00mm),the difference is statistically significant (P＜0.01,respectively). The LVD of patients with AC Child - Pugh B class (48.83±1.07mm) compares with AC Child - Pugh A class (48.00±0.00mm), the difference is not statistically significant (P> 0.05).1.2.2 The LVD of patients with HBC Child - Pugh C class (50.56±1.97mm) is respectively larger than patients with HBC Child - Pugh B class (49.49±1.63mm), Child - Pugh A class (47.25±1.24mm), the difference is statistically significant (P<0.01,respectively). The LVD of patients with HBC Child - Pugh B class (49.49±1.63mm) compares with HBC Child - Pugh A class (47.25±1.24mm), the difference is statistically significant (P＜0.01).2. The comparison of LVD from patients with AC, patients with HBC and healthy controls.2.1 Horizontal analysis2.1.1The EF of patients with AC Child - Pugh A, B, C class (61.00±1.41%、 65.07±2.36%、59.86±3.63%) is respectively lower than control group (67.47± 2.68%), the difference is statistically significant (P＜0.01,respectively).2.1.2 The EF of patients with HBC Child - Pugh B, C class (64.32±2.81%、 61.44±3.36%)is respectively lower than control group(67.47±2.68%),the difference is statistically significant (P<0.01,respectively). The EF of patients with HBC Child- Pugh A class (69.00±1.86%) compares with control group (67.47±2.68%), the difference is not statistically significant (P> 0.05).2.1.3 The EF of patients with AC Child - Pugh A, C class (61.00±1.41%、 59.86±3.63%)is respectively larger than patients with HBC Child - Pugh A, C class (69.00±1.86%、61.44±3.36%), the difference is statistically significant (P＜0.01, respectively).The EF of patients with alcoholic cirrhosis Child - Pugh B class (65.07±2.36%) compares with HBC Child - Pugh B class (64.32±2.81%), the difference is not statistically significant (P> 0.05).2.2 Vertical analysis2.2.1 The EF of patients with AC Child - Pugh C class (59.86±3.63%) is lower than patients with AC Child - Pugh B class (65.07±2.36%), the difference is statistically significant (P＜0.01). The EF of patients with AC Child - Pugh C class (59.86±3.63%) compares with AC Child-Pugh A class (61.00±1.41%) and the EF of patients with AC Child - Pugh B class (65.07±2.36%) compares with AC Child-Pugh A class (61.00±1.41%), the difference is not statistically significant (P > 0.05,respectively).2.2.2 The EF of patients with HBC Child - Pugh C class (61.44±3.36%) is respectively lower than patients with HBC Child - Pugh B class (69.00±1.86%), Child - Pugh A class (64.32±2.81%), the difference is statistically significant (P＜0.01,respectively). The EF of patients with HBC Child - Pugh B class ((69.00±1.86%) compares with HBC Child - Pugh A class (64.32±2.81%), the difference is statistically significant (P＜0.01).Conclusion:1. Both alcoholic cirrhosis and hepatitis B cirrhosis of Child - Pugh B,C class have myocardial disease: left ventricular ejection fraction is lower or(and) left ventricular diameter is lager.2. When Child-Pugh class is same, the change of left ventricular form and systolic function with alcoholic cirrhosis is severer than hepatitis B cirrhosis.3. With the increase of Child-Pugh class, the change of left ventricular form and systolic function with hepatitis B cirrhosis is more remarkable. But for patients with alcoholic cirrhosis, only Child-Pugh C class is respectively severer than Child-Pugh A class, Child - Pugh B class.