QRS波群时限及血浆BNP与慢性心力衰竭致心源性猝死的相关性研究

Correlation between QRS complex duration and plasma BNP and occurrence of sudden cardiac death in patients with chronic heart failure

目的:探究QRS波群时限和血浆脑钠肽(BNP)与慢性心力衰竭(chronic heart failure,CHF)导致心源性猝死(sudden cardiac death,SCD)的相关性。方法:选择本院接受治疗的CHF病患258例,并记为观察组。随机选取同期进行健康体检的志愿者250例,记为对照组。对所有病患进行基本资料记录,对比两组的LVEF、左室舒张末期内径、QRS波群时限以及BNP。结果:观察组出现高血压、高血脂、糖尿病、DCM以及ICM的比例更大,LVEF更低,并且左室舒张末期内径、QRS波群时限以及BNP更大,差异均有统计学意义(P<0.05);在所有CHF中,SCD病患占10.47%(27/278)。根据Logistic回归性分析得到CHF导致SCD的4个相关因素,即:LVEF、左室舒张末期内径、QRS波群时限以及BNP等。结论:CHF病患存在高血压、高血脂等危险因素,并且当CHF病患QRS波群时限和血浆BNP增大时提示SCD出现的风险大。

Objective： To explore the correlation between QRS complex duration and brain natriuretic peptide （BNP） and occurrence of sudden cardiac death （SCD） in chronic heart failure （CHF）. Methods： A total of 258 patients with CHF treated in this hospital were selected as the observation group. 250 volunteers who received the health examination over the same period were randomly selected as the control group. The basic data of all patients was recorded. Then compared LVEF, left ventricular end-diastolic diameter, QRS complex duration and BNP between two groups. Results： The proportion of hyperten- sion, hyperlipidemia, diabetes, DCM and ICM was higher in the observation group, while LVEF was lower and left ventricular end-diastolic diameter, QRS complex duration and BNP were higher than those in the control group. Patients with SCD occupied 10.47 % （27/278） of all patients with CHF. According to the logistic regression analysis, it obtained 4 related factors for SCD in patients with CHF, namely LVEF, left ventricular end-diastolic diameter, QRS complex duration and BNP, with the statistical difference between two groups （P〈0.05）. Conclusion.. Patients with CHF may have the dangerous factors of hypertension and hyperlipidemia. In addition, the increase of QRS complex duration and plasma BNP indicate high risk of SCD for patients with CHF.