不同类型束支阻滞患者心功能的相关分析

The correlated analysis of cardiac function in patients with different types of bundle branch block

目的探讨不同类型及同种类型不同QRS时限束支传导阻滞患者的心功能差异。方法将285例束支传导阻滞患者按阻滞类型分为左束支传导阻滞组(A组,n=105)和右束支传导阻滞组(B组,n=180);依据QRS时限将A、B两组分为A1组(n=49)、B1组(n=126)(两者QRS时限均<150 ms)或者A2组(n=56)、B2组(n=54)(两者QRS时限≥150 ms)。对比分析不同类型及同种类型不同QRS时限传导阻滞患者的常规心脏超声及心电图等心功能相关指标间的差异。结果 A、B两组在同一QRS时限时两者的LVEF(左室射血分数),FS(左室短轴缩短率)及BNP差异有统计学意义(P<0.05);B组收缩功能指标在不同QRS时限时差异有统计学意义(P<0.05),心率与QRS时限正相关(r=0.176,P<0.05)。结论右束支传导阻滞组的心功能在QRS时限各水平均优于左束支阻滞组,随着QRS时限延长左束支阻滞组患者心功能下降更明显,整体而言无论束支阻滞形态如何,心率均随着QRS时限延长而增快。

Objective To investigate the differences of cardiac function in patients with different types of bundle branch block and different duration of QRS. Methods According to the type of bundle branch block , 285 patients with bundle branch block were divided into left bundle branch block（LBBB） group（group A, n=105） and right bundle branch block（RBBB） group（group B, n=180）. On the basis of the QRS duration, group A and group B were divided into group Al（n=49） or Bl（n=126）（QRS duration 〈150 ms） and group A2（n=56） or B2（n=54） group （equal to or more than 150 ms）. The differences of the related indexes of cardiac function which were between patients with different types of bundle branch block and with different QRS duration in normal cardiac ultrasound and electrocardiogram and something else were compared. Results In the same QRS duration, the difference of LVEF （left ventricular ejection fraction）, FS （left ventricular short axis shortening rate） and BNP（Brain Natriuretic Peptide） in group A and group B were statistically sig- nificant（P〈0.05）; In different QRS duration, systolic function indexes in group B were statistically significant （P〈0.05）. Heart rate was positively associated with QRS duration（r=0.176, P〈0.05）. Conclusion At each level of QRS duration, the heart function in the group of RBBB block is better than group of LBBB. As QRS duration prolongs, the cardiac func tion of patients with LBBB decreases more significantly. Whether what the bundle branch block＇s morphology is, when QRS duration prolongs, heart rate increases.