摘要
目的 探讨不同类型心力衰竭患者心电图QRS波时限与血浆脑钠肽水平的关系.方法 连续纳入2016年2月至2017年6月期间在天津市第三中心医院分院心内科住院的慢性心力衰竭患者（CHF）134例,根据射血分数分为REF组（LVEF＜45％,n=60）和PEF组（LVEF≥45％,n=74）;对照组入选同期住院无心衰的冠心病患者60例.各组患者分别测量心电图QRS波时限、BNP水平及左室射血分数（LVEF）等相关指标,比较CHF组与对照组、REF组与PEF组间心电图QRS波时限、BNP水平的差异,以及REF组QRS波时限与BNP及LVEF的相关性.结果 CHF组QRS波时限显著长于对照组[（118.76± 19.90）ms比（82.65 ±6.16）ms,P＜0.05],BNP水平亦高于对照组[（587.73±642.30）pg/ml比（52.99±12.43） pg/ml,P＜0.05],LVEF低于对照组[0.48±0.11比0.59±0.05,P＜0.05].REF组QRS波时限显著长于PEF组[（136.43±10.86）ms比（102.62±10.07）ms,P＜0.05],BNP水平高于PEF组[（1071.44±625.68）pg/ml比（145.49±149.45）pg/ml,P＜0.05].相关性分析显示,REF组QRS波时限与BNP呈正相关（r=0.669,P=0.000）,与LVEF呈负相关关系（r=-0.176,P=0.000）.结论 老年心力衰竭患者QRS波时限较长,血浆BNP水平较高,并且不同类型心力衰竭患者也存在差异.QRS波时限和血浆BNP水平可用于辅助判断心力衰竭类型及心功能状况.
Objective To analyze the correlation between electrocardiogram QRS complex duration and brain natriuretic peptide （BNP） in patients with different clinical phenotypes of chronic heart failure （CHF）.Methods CHF patients（n=134） were chosen continuously from Feb.2016 to Jun.2017 as CHF group,and other patients without CHF （n=60） were chosen at the same time as control group.CHF group was subgrouped into reduced left ventricular ejection fraction heart failure group（REF,LVEF〈45%,n=60） and preserved left ventricular ejection fraction heart failure group （PEF,LVEF ≥45,n=74） according to left ventricular ejection fraction （LVEF）.The QRS complex duration and the level of BNP were detected in all groups.The changes of LVEF were detected by using color Doppler echocardiogram.The difference in QRS complex duration and BNP were analyzed between CHF group and control group and among all subgroups.The correlation between QRS complex duration and BNP and LVEF was studied.Results The QRS complex duration and BNP were significantly increased in patients in CHF than that in control group [（118.76±19.90）ms vs.（82.65±6.16）ms,（587.73±642.30）pg/ml vs.（52.99±12.43）pg/ml,P〈0.05].The QRS complex duration and BNP were significantly increased in patients in REF group than that in PEF group [（136.43±10.86）ms vs.（102.62±10.07）ms,（1071.44±625.68）pg/ml vs.（145.49±149.45）pg/ml,P〈0.05].The QRS complex duration was correlated positively with plasma levels of BNP （r=0.669,P=0.000） and was correlated negatively with LVEF （r=-0.176,P=0.000）.Conclusion The QRS complex duration is longer and the level of BNP is higher in CHF patients,and different types of heart failure patients are also different.The QRS complex duration and the level of BNP can be used to help the diagnosis of heart failure types and cardiac function.
作者
宋翠
郑刚
SONG Cui;ZHENG Gang.(Department of Cardiology, Tianjin Third central Hospital, Tianjin 300250, Chin)
出处
《中国心血管病研究》
CAS
2018年第5期432-435,共4页
Chinese Journal of Cardiovascular Research
关键词
心力衰竭
QRS波
脑钠肽
Heart failure
QRS complex duration
Brain natriuretic peptide
