慢性收缩性心力衰竭患者V1导联P波终末电势及其与NT-ProBNP的关系

Relationship between P wave terminal force in lead V1 and N terminal pro-Brain Natriuretic Peptide in patients with chronic systolic heart failure

目的探讨慢性收缩性心力衰竭患者V1导联P波终末电势(P wave terminal force in lead V1,Ptf V1)及其与其血清N端B型脑钠肽前体(N terminal pro-Brain Natriuretic Peptide,NT-Pro BNP)之间的联系。方法将80例慢性收缩性心力衰竭的住院患者根据NYHA心功能分级分为NYHAⅠ、Ⅱ级组(n=45),NYHAⅢ、Ⅳ级组(n=35),对照组为同期入院的无器质性心脏病变的心功能正常组(n=22),分别测定外周血NT-Pro BNP水平,并记录V1导联P波终末电势,采用SPSS 19.0进行统计学分析。结果 1慢性收缩性心力衰竭患者Ptf V1水平(-0.067±-0.023)显著低于对照组(-0.025±-0.011)(P<0.05),慢性收缩性心力衰竭患者NT-Pro BNP(2 314.21±1 465.19)水平显著高于对照组(78.33±14.33)(P<0.05);2慢性收缩性心力衰竭患者各亚组中Ptf V1水平[NYHAⅠ、Ⅱ级组(-0.053±-0.010)、NYHAⅢ、Ⅳ级组(-0.086±-0.022)]显著低于对照组(-0.025±-0.011)(P<0.05),慢性收缩性心力衰竭患者各亚组中NT-Pro BNP水平[NYHAⅠ、Ⅱ级组(1 167.15±224.46)、NYHAⅢ、Ⅳ级组(3 887.31±838.39)]显著高于对照组(78.33±14.33)(P<0.05),且随着心功能分级的增加Ptf V1水平下降,NT-Pro BNP水平增加(P<0.05);3慢性收缩性心力衰竭患者Ptf V1与其NT-Pro BNP水平呈负相关(r=-0.716,P<0.05)。结论慢性收缩性心力衰竭患者V1导联P波终末电势(Ptf V1)负值增大,并且与其NT-Pro BNP水平升高密切相关,Ptf V1负值增大可作为慢性收缩性心力衰竭患者心功能恶化的实用指标。

Objective To investigate the relationship between P wave terminal force in lead V1 and N terminal pro-Brain Natriuretic Peptide in patients with chronic systolic heart failure. Methods A total of 80 inpatients diagnosed as chronic systolic heart failure were included in this study. They were divided into 2 groups according to New York Heart Association：（ NYHA）Functional Classification Ⅰ、Ⅱ group（ n = 45）,（ NYHA） Functional Classification Ⅲ、Ⅳ group（ n = 35）. Control group was consisted of patients hospitalized at the same period without structural heart disease and in normal cardiac functional class（ n =22）; The P wave terminal force in lead V1 were recorded and the level of NT-Pro BNP was measured respectively. Statistical analysis was performed by SPSS 19. 0. Results 1 The Ptf V1（-0. 067 ±-0. 023） in chronic systolic heart failure groups were significantly lower than control group（-0. 025 ±-0. 011）（ P〈0. 05）. The NT-Pro BNP levels（ 2 314. 21 ± 1 465. 19） in chronic systolic heart failure groups were significantly higher than control group（ 78. 33 ± 14. 33）（ P〈0. 05）. 2The Ptf V1 levels in different subgroups[NYHA Ⅰ、Ⅱ group（-0. 053 ±-0. 010） 、NYHA Ⅲ、Ⅳ group（-0. 086 ±-0. 022） ]were significantly lower compared with control group（-0. 025 ±-0. 011）（ P〈0. 05）. The NT-Pro BNP levels in different subgroups[（ NYHA Ⅰ、Ⅱ group（ 1 167. 15 ± 224. 46）,NYHA Ⅲ、Ⅳ group（ 3 887. 31 ± 838. 39） ]were significantly higher compared with control group（ 78. 33 ± 14. 33）（ P〈0. 05）,and the The Ptf V1 decreased but NT-Pro BNP level increased with the growing of NYHA functional class（ P〈0. 05）. 3In correlation analysis,Ptf V1 showed significant correlation with plasma NT-Pro BNP levels（ r =-0. 716,P〈0. 05）. Conclusion Ptf V1 negative value in patients with chronic systolic heart failure increases and it was closely relative with NT-Pro BNP levels,which could act as a practical indicator that reflect the deterioration of cardiac function of patients with chronic systolic heart failure.