冠心病心力衰竭患者血清HCY水平、心电图QRS波时限与心功能的相关性分析

Correlation between HCY level,QRS time limit of ECG and cardiac function in patients with coronary heart disease and heart failure

目的分析冠心病心力衰竭患者血清同型半胱氨酸(HCY)水平、心电图QRS波时限与心功能的相关性。方法选取2015年4月至2018年4月本院收治的101例冠心病患者临床资料,按照是否伴心力衰竭分为A组(n=51)、B组(n=50)。按照美国纽约心脏病学会对A组进行心功能分级,另分为三个亚组(Ⅱ级组:17例;Ⅲ级组:19例;Ⅳ级组:15例)。同时纳入同期健康体检结果正常者52例作为对照组。收集所有研究对象一般资料。比较A、B组血清HCY水平和QRS波时限差异,采用Pearson相关分析分别观察冠心病心衰患者血浆HCY水平和QRS波时限与心功能分级的关系。结果 3组血清HCY水平、血浆BNP水平、LVEDD、QRS波时限比较结果:A组>B组>对照组;LVEF:A组Ⅲ级组>Ⅱ级组;LVEF比较结果:Ⅳ级组<Ⅲ级组<Ⅱ级组,差异均具有统计学意义(P<0.05)。冠心病心力衰竭患者HCY水平与血浆BNP浓度、LVEDD值呈正相关,与LVEF值呈负相关(P<0.05)。冠心病心力衰竭患者QRS波时限与血浆BNP浓度、LVEDD值及血清HCY水平呈正相关,与LVEF值呈负相关(P<0.05)。结论 HCY水平及QRS波时限在冠心病心力衰竭患者中异常增高,且与患者心功能具有显著相关性,两者结合可作为对评价冠心病心力衰竭患者心功能损害程度的有效指标,值得临床推广。

Objective To analyze the correlation between serum homocysteine(HCY)level,QRS time limit of ECG and cardiac function in patients with coronary heart disease and heart failure.Methods The clinical data of 101 patients with coronary heart disease admitted to our hospital from April 2015 to April 2018 were analyzed.They were divided into group A(n=51)and group B(n=50)according to whether they were ac⁃companied by heart failure.Based on the standards of the New York Society of Cardiology,the cardiac function was graded and divided into three subgroups(Ⅱgroup:17 cases;Ⅲgroup:19 cases;Ⅳgroup:15 cases).At the same time,52 patients with normal results in physical examination in this hospital during the same period were included as the control group.The general data of all the subjects were collected.The differences in serum HCY levels and QRS duration between groups A and B were compared.Pearson correlation analysis was used to observe the correlation between the plasma HCY level and QRS time limit and the cardiac function classification in patients with coronary heart disease and heart failure.Results The comparison of serum HCY levels,plas⁃ma BNP levels,LVEDD and QRS wave time limits in the three groups was as follows:group A>group B>the control group;LVEF levels are as follows:group A<group B<the control group,the differences were statis⁃tically significant(P<0.05).The comparison of serum HCY levels,plasma BNP levels,LVEDD,QRS wave time limits among the three groups were as follows:Grade IV group>GradeⅢgroup>GradeⅡgroup.The LVEF levels were as follows:Grade IV group<GradeⅢgroup<GradeⅡgroup,the difference is statistically significant(P<0.05).HCY levels in patients with coronary heart disease and heart failure were positively corre⁃lated with plasma BNP concentrations and LVEDD values,and negatively correlated with LVEF values(P<0.05).QRS wave duration in patients with coronary heart disease and heart failure was positively correlated with plasma BNP concentration,LVEDD value and serum HCY level,and negatively correlated with LVEF value(P<0.05).Conclusions HCY level and QRS wave duration abnormally increased in patients with coronary heart disease and heart failure and have a significant correlation with the patient􀆳s heart function.The combina⁃tion of the two can be used as effective index to evaluate the degree of heart damage in patients with coronary heart disease and heart failure,and it is worthy of clinical promotion.