冠心病心力衰竭患者QRS波时限与血浆Hcy的相关性分析

Correlation analysis of plasma Hcy and QRS duration in coronary heart disease patients with heart failure

目的探讨冠心病心力衰竭患者QRS波时限与血浆同型半胱氨酸(Hcy)的水平,分析其相关性。方法将观察组110例冠心病心力衰竭患者根据纽约心脏病协会(NYHA)分级将其分为Ⅱ、Ⅲ、Ⅳ级3个亚组。另选入冠心病稳定型心绞痛患者为冠心病对照组,非冠心病慢性心力衰竭患者为心衰对照组,健康志愿者为健康对照组。测量所有受试者心功能指标、血浆脑钠肽(BNP)、左室舒张末期内径(LVEDD)、同型半胱氨酸(Hcy)和QRS波时限。结果观察组、冠心病对照组及心衰对照组的BNP、LVEDD、Hcy和QRS波时限水平显著高于健康对照组,LVEF显著低于健康对照组,且观察组BNP、LVEDD、Hcy和QRS波时限水平显著高于冠心病对照组和心衰对照组,LVEF则显著低于冠心病对照组和心衰对照组,差异均有统计学意义(P<0.05);观察组Hcy和QRS波时限值随心功能分级升高而增加(P<0.05);Pearson相关分析显示,Hcy和QRS波时限呈显著正相关(P<0.001),Hcy、QRS波时限与BNP、LVEDD均呈显著正相关,与LVEF呈显著负相关。结论冠心病心力衰竭患者血浆Hcy显著升高且随心功能分级的增加而增加,Hcy与QRS波时限呈显著正相关,两者联合检查可以作为评价冠心病心力衰竭患者心功能状况的重要指标。

Objective To explore the levels of plasma Hcy and QRS duration in coronary heart disease （CHD） patients with heart failure（HR） , and analyze the correlation between them. Methods Total 110 cases CHD patients with heart failure in the observation group were divided into Ⅱ , Ⅲ, Ⅳ subgroups according to the NYHA class. The patients with stable coronary artery disease angina were selected as the CHD control group, the non-CHD patients with heart failure were selected as the heart failure control group, and the healthy volunteers were as healthy control. The cardiac function index, levels of brain natriuretic peptide（BNP） and Homocysteine（Hey） , and QRS wave duration of all the subjects were meas- ured. Results The levels of BNP and Hey, LVEDD and QRS duration in the observation group, HF control group and CHD control group were significantly higher than that of healthy control group, LVEF was significantly lower than that in the healthy control group, the differences were statistically significant（ P 〈 0.05 ） ; the levels of Hcy and QRS duration with m and IV heart function class were significantly higher than that with the Ⅱ heart function class, Hcy level and QRS du- ration in IV heart function class were significantly higher than the Ⅲ heart function class, the differences were statistically significant（P 〈 0.05 ）;Pearson correlation analysis showed that Hcy level and QRS duration were significantly positive correlation（ P 〈 0. 001 ;Hcy level and QRS duration were positively related to BNP level and LVEDD, and negative corre- lated with LVEF. Conclusion The level of plasma Hcy is significantly high in CHD patients with heart failure, and in- crease with the NYHA class. Hcy level is significantly positively related to QRS duration. The combined tests of Hey level and QRS duration can be used as an important index in evaluating the cardiac function status of CHD patients with heart failure.