慢性心力衰竭患者QRS波时限与血浆脑钠肽及左心室射血分数的相关性分析

Correlation analysis between QRS duration with plasma brain natriuretic peptide and left ventricular ejection fraction in patients with chronic heart failure

目的研究慢性心力衰竭患者QRS波时限与血浆脑钠肽及左心室射血分数的相关性。方法选择2012年1月～2014年12月在河北省平山县人民医院进行诊治的慢性心力衰竭患者200例为观察组，另选60例进行体检的健康者为对照组。对所有研究对象进行心电图检查，检测V5导联最宽QRS波时限。比较两组的QRS波时限、血浆脑钠肽和左心室射血分数，并进行相关性分析。结果观察组的QRS波时限和血浆脑钠肽水平均明显高于对照组（P＜0.01），左心室射血分数明显低于对照组（P＜0.01）；QRS波时限≤120ms有112例，QRS波时限＞120ms有98例，QRS波时限≤120ms组的血浆脑钠肽水平明显低于QRS波时限＞120ms组（P＜0.01），左心室射血分数明显高于QRS波时限＞120ms组（P＜0.01）；Pearson相关分析结果显示，观察组QRS波时限与血浆脑钠肽呈明显正相关（r=0.815，P＜0.01），与左心室射血分数呈明显负相关（r=-0.723，P＜0.01）。结论慢性心力衰竭患者体表心电图QRS波时限明显延长，且与血浆脑钠肽及左心室射血分数存在显著相关关系，可作为临床评价慢性心力衰竭患者心脏功能的重要辅助指标。

Objective To investigate the correlation of QRS duration with plasma brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) in patients with chronic heart failure (CHF). Methods 200 CHF patients in Pingshan County People's Hospital from January 2012 to December 2014 were selected as observation group, 60 healthy persons were selected as control group. All participants were taken ECG examination, and the widest V5 lead QRS duration was measured. The QRS duration, plasma BNP and LVEF were compared between two groups, and the correlation was analyzed. Results The QRS duration and level of plasma BNP in observation group was significantly higher than control group (P<0.01). LVEF in observation group was significantly lower than control group (P<0.01). 112 patients had shorter QRS duration (≤120 ms), and 98 patients had longer QRS duration (>120ms). Level of plasma BNP in patients with shorter QRS duration were significantly lower than patients with longer QRS duration (P<0.01). LVEF in patients with shorter QRS duration was significantly higher than patients with longer QRS duration (P<0.01). Result of pearson correlation analysis showed that QRS duration and of observation group was significantly positively correlated with plasma BNP (r=0.815, P<0.01), but significantly negatively correlated with LVEF (r=-0.723, P<0.01). Conclusion The QRS duration of CHF patients is significantly increased, and significantly correlated with plasma BNP and LVEF, which can be used as an important auxiliary indicator for cardiac function in patients with CHF.