慢性心力衰竭患者心室失同步化与QRS波时间及脑钠肽血浓度相关性研究

An Investigation about Correlations of Ventricular Dyssynchronization,QRS Duration and the Levels of B - type Natriuretic Peptide in Patients with Chronic Heart Failure

目的:研究慢性心力衰竭(CHF)患者心室失同步化(Ventricular dyssynchronization,VD)与QRS波时限及血中脑钠肽浓度的关系。方法:选择CHF病人154例,根据同步12导心电图检测QRS波时限分为≥120ms为A组(n=56例)与<120ms为B组(n=98例),两组又根据心脏彩超检测是否有VD分为A1亚组(n=42例)、A2亚组(n=14例)与B1亚组(n=47例)、B2亚组(n=51例),各亚组患者均检查血液中脑钠肽浓度,A组与B组比较VD情况,四个亚组之间比较脑钠肽浓度水平。结果: A组与B组患者VD情况有明显差异性,但既使是QRS波时限<120ms者仍有42．9％患者心室运动失同步化;四个亚组对比,不论QRS波时限如何VD患者较心室非失同步化患者血中脑钠肽浓度明显升高,有显著差异性。结论:QRS波时限并不能完全反映VD运动状态,尽管有一定的联系性。CHF患者血中脑钠肽水平可敏感反映VD情况。

Objective： To investigative the correlations of ventricular dyssynchronization（VD）, QRS duration（QRSD） and the levels of B - type natriuretic peptide（BNP） in patients with chronic heart failure（CHF） .Methods： A total of 154 outpatients and inpatients with CHF were divided into two groups according to QRSD. A group （n = 56, QRSD 〉 120ms）, B group （n = 98, QRSD 〈 120ms） . Every group was divided into two subgroups in accordance with the conditions of VD, A1 subgroup （n = 42）, A2 subgroup（n = 14）, B1 subgroup（n = 47） and B2 subgroup（n = 51） Tile blood concentration of BNP were measured in all patients. Results： There was visible difference in the condition of VD between the patients in group A and group B. But, there was remain 42.9% cardiac ventricle dyssynchronization in the group of QRSD 〈 120ms;The blood concentration of BNP in patients with VD was higher than that of the patients with normal ventricle motion whatever the QRSD was. Conclusion： The QRSD could not reflect the condition of VD completely, although there axe some connection with them. The blood concentration of BNP in patients with CHF can sensitively reflect the condition of VD.