不同类型心力衰竭患者心电图QRS波时限与血浆NT-proBNP水平的关系及其临床意义

目的：探讨不同类型心力衰竭患者心电图QRS 波时限与血浆N末端B型利钠肽原（NT-proBNP）水平之间的关系及其临床 意义。方法：选择我院2012 年7 月至2014 年6 月接收的慢性心力衰竭患者300 例，作为研究组，将患者分为收缩性心力衰竭组 （S组）和舒张性心力衰竭组（D组）；另外，选取我院非CHF 患者132 例，作为对照组。测定所有受试者的心电图QRS 波时限，及 血浆中NT-proBNP 水平，分析血浆NT-proBNP 水平与QRS 波时限及NYHA心功能分级关系。结果：与对照组相比，研究组QRS 波时限均延长，血浆NT-proBNP水平显著升高（P<0.05），其中S 组比D 组明显延长，且S 组血浆NT-proBNP水平高于D 组 （P<0.05）。三组NYHA 分级对比发现，差异均具有统计学意义（P<0.05）；S 组患者血浆NT-proBNP水平与QRS 波时限及NYHA 心功能分级之间呈正相关；D 组患者血浆NT-proBNP水平与QRS 波时限及NYHA心功能分级之间无明显的相关性。结论：临床 上可以将NT-proBNP水平和QRS 波时限结合起来诊断慢性心力衰竭患者的类型，以便于之后的治疗。

Correlation Between ElectrocardiogramQRS Wave Duration and Plasma NT-proBNP Level in Different Types of Heart Failure

Objective:To explore the clinical value and correlation between electrocardiogram QRS wave duration and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in different types of heart failure.Methods:A total of 300 patients with chronic heart failure (CHF), who were admitted to Second Affiliated Hospital of Xinjiang Medical University from July 2012 to June 2014, were chosen as research group which was divided into systolic heart failure group(group S), and diastolic heart failure group(group D). Meanwhile, 132 patients without CHF, as control group. The QRS wave duration and the plasma NT-proBNP levels of all the patients were detected and analyzed. The correlation between the plasma NT-proBNP levels and QRS wave duration and NYHA classification was analyzed.Results:Compared with the control group, the QRS wave duration was prolonged, and plasma NT-proBNP level of the research group increased (P<0.05), in which the QRS wave duration of group S was longer than that of group D, and plasma NT-proBNP level was higher than that of groupD (P<0.05). There were significant differences in NYHA classification among the three groups (P<0.05). There was a positive correlation among NT-proBNP level and QRS wave duration and NYHA classification in group S, while there was no obvious positive correlation among NT-proBNP level and QRS wave duration and NYHA classification in group D.Conclusion:NT-proBNP level and QRS wave duration can be combined to diagnose the types of patients with CHF, which will be helpful for the further treatment.