QRS波时限和血浆同型半胱氨酸检查在冠心病心力衰竭患者中的意义

Significance of QRS wave duration and plasma homocysteine levels in patients with coronary heart disease and heart failure

目的:探讨QRS波时限和血浆同型半胱氨酸(Hcy)水平检查与冠心病心力衰竭的相关性。方法:选择冠心病心力衰竭患者98例,按照患者心功能分级分为A(38例)、B(31例)、C(29例)3组,选取同期健康体检者30例作为D组;测定各组BNP、LVEF、QRS波时限、Hcy水平。结果:A、B、C 3组BNP、QRS波时限、Hcy水平明显高于D组,LVEF明显低于D组,差异具有统计学意义(P<0.05);随着心功能分级增加,A、B、C 3组BNP、Hcy、QRS波时限逐渐升高,LVEF逐渐降低,差异具有统计学意义(P<0.05);Pearson相关性分析得出,血浆Hcy水平与BNP、QRS波时限呈正相关(r=0.573,0.661,P<0.05),与LVEF水平呈负相关(r=-0.732,P<0.05);QRS波时限与BNP水平呈正相关(r=0.559,P<0.05),与LVEF水平呈负相关(r=-0.691,P<0.05)。结论:冠心病心力衰竭患者QRS波时限与血浆Hcy水平呈正相关,可作为早期评价心功能状况的可靠指标。

Objective： To investigate the correlation between QRS duration and plasma homocysteine level and coronary heart disease（ CHD） with heart failure. Methods： 98 patients with coronary heart disease and heart failure were randomly divided into three groups： A（ 38 cases）,B（ 31 cases） and C（ 29 cases）. The30 healthy subjects were set as D group,BNP,LVEF,QRS wave duration and Hcy level were measured in these groups. Results： The levels of BNP,QRS wave and Hcy in group A,B and C were significantly higher than those in group D,LVEF was significantly lower than that in group D with the difference statistical significance（ P〈0.05）. With the increase of cardiac function classification,BNP,Hcy and QRS wave was gradually increased and LVEF gradually decreased,the difference was statistically significant（ P〈0.05）. The plasma Hcy level was positively correlated with BNP and QRS wave（ r = 0.573,0.661,P〈0.05）,and negatively correlated with LVEF level（ r =-0. 732,P〈0. 05）. QRS wave duration was positively correlated with BNP level（ r = 0.589,P〈0.05） and negatively with LVEF level（ r =-0.691,P〈0.05）. Conclusion： The QRS duration in patients with coronary heart disease and heart failure is positively correlated with plasma Hcy level,which can be used as a reliable index for early evaluation of cardiac function.