心力衰竭患者心电图QRS波时限、NT-proBNP水平及相关性分析

The QRS wave duration and NT-proBNP levels in patients with different types of heart failure and their correlation

目的探讨心力衰竭患者心电图QRS波时限、N末端B型利钠肽原(NT-proBNP)水平状况,并分析QRS波时限与NT-proBNP水平的关系。方法回顾性分析2019年6月至2020年4月诊治的130例心力衰竭患者临床资料作为研究组,根据心力衰竭类型分为收缩组(n=66例)和舒张组(n=64例)。另外选取60例同期非心力衰竭患者作为对照组。患者均实行动态心电图检查QRS波时限,统计所有患者的NT-proBNP水平,并探讨QRS波时限与NT-proBNP水平的关系。结果研究组的QRS波时限[(128.6±7.3)ms]高于对照组[(80.3±7.1)ms],NT-proBNP水平[(1244.6±10.3)pg/ml]明显高于对照组[(105.3±5.4)pg/ml],LVEF(55.23±5.58)%低于对照组(68.33±5.19)%,差异均有统计学意义(P<0.05)。收缩组患者的QRS波时限[(135.6±12.5)ms]高于舒张组[(100.5±12.9)ms],血浆NT-proBNP水平[(1248.6±12.6)pg/ml]高于舒张组[(665.4±17.2)pg/ml],LVEF(38.89±5.46)%低于舒张组(59.22±6.78)%,差异有统计学意义(均P<0.05)。不同NYHA分级的QRS波时限、NT-proBNP、LVEF水平比较,差异有统计学意义(P<0.05)。经线性相关性分析,收缩组患者的QRS波时限与血浆NT-proBNP水平之间呈正相关关系(P<0.05),与LVEF呈负相关性(P<0.05)。结论心力衰竭心电图QRS波时限为慢性心力衰竭患者心功能指标一个重要评价指标,联合血浆NT-proBNP水平测定,可用于辅助评估心力衰竭患者类型,指导临床治疗。

Objective To investigate the QRS wave duration and N-terminal B-type natriuretic peptide(NT-proBNP)levels in patients with different types of heart failure and their correlation.Methods The clinical data about 130 patients with heart failure who were treated in our hospital retrospectively analyzed(observation group).According to the different types of heart failure,the patients were divided into systole group(n=66)and diastole group(n=64).Meanwhile the other 60 patients with non heart failure were enrolled as control group.All the patients underwent ambulatory ECG to check the QRS wave time limit,and the NT-proBNP levels were detected.Moreover the correlation between QRS wave duration and NT-proBNP level was analyzed.Results The QRS time limit and NT-proBNP levels in observation group were significantly higher than those in control group(P<0.05),however,the LVEF levels were significantly lower than those in control group(P<0.05).Moreover the QRS wave duration and plasma NT-proBNP levels in systole group were significantly higher than those in diastole group,however,the LVEF levels were significantly lower than those in diastole group(P<0.05).There were significant differences in QRS wave duration,NT-proBNP and LVEF levels in different NYHA grades(P<0.05).The linear correlation analysis showed that there was a positive correlation between QRS wave duration and plasma NT-proBNP level and a negative correlation between QRS wave duration and LVEF(P<0.05).Conclusion The time limit of ECG QRS wave is an important index of evaluating cardiac function of patients with chronic heart failure,combining it with the detection of plasma NT-proBNP level can be used to assistantly evaluate the types of heart failure,so as to guide clinical treatment.