绝经后女性心衰患者脑钠肽与QRS波意义

Values of brain natriuretic peptide level and QRS duration in postmenopausal women with heart failure

目的 探讨血浆脑钠肽（BNP）与QRS波时间对绝经后女性心衰患者的心功能判断和短期预后的临床应用价值。方法对101例人选患者的心功能分级（Ⅱ—Ⅳ级），心电图QRS波宽度，血浆BNP结果进行分组比较，并对入选患者随访12周结果进行回顾分析。结果绝经后女性心力衰竭患者BNP≥800pg／ml组心功能明显比BNP〈800pg／ml差（P〈0．05），提示BNP越高时，心功能越差，而且随NYHA分级级数越高，BNP数值越大；另外，QRS≥120ms组心功能明显比QRS〈120ms差（P〈0．05），提示QRS波增宽越大，心功能越差，但是，QRS波增宽与NYHA分级相关性差；对于绝经后女性心力衰竭患者，BNP与QRS波时间两者又都是死亡和预后不良的独立危险预测因子。结论对绝经后女性心力衰竭患者的诊治，可结合BNP增高和QRS增宽来提示心功能的恶化和预后不良，是一种简便而行之有效的方法。

Objective To analyze the clinical values of plasma brain natriuretic peptide （ BNP ） level and QRS duration in the detection of heart function and the prediction of prognosis in postmenopausal women with heart failure. Methods NYHA class was evaluated and QRS duration and plasma BNP level were measured and compared in one hundred and one postmenopausal women with heart failure. The outcomes of follow-up were analyzed. Results The higher the plasma BNP level, the worse the heart function; and the BNP value elevated with an increase in NYHA class. The wider the QRS complex, the poorer the heart function; but QRS duration was poorly associated with NYHA class. Multivariate analysis showed that prolonged QRS duration and elevated BNP level were the two independent risk factors of death or poor prognosis. Conclusion An elevated BNP level combined with prolongation of QRS duration are simple and effective in predicting worsening of heart function and poor prognosis in postmenopausal with heart failure.