不同类型的QRS波增宽与心力衰竭的相关性.pdf

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1、中国现代药物应用2014年8月第8卷第16期ChinJM0dDragADo1，Aug2014，Vo1．8，N0．16·5·不同类型的QRS波增宽与心力衰竭的相关性赵杰娉崔天祥方慧玲【摘要】目的探讨不同类型的QRS波增宽与N末端B型脑钠肽前体(NT—proBNP)水平及左心室射血分数(LVEF)的相关性。方法QRS波时限>120ms的慢性心力衰竭患者97例，根据QRS波分为左束支组47例、右束支组50例，非慢性心力衰竭且QRS波时限正常者40例作为对照组。分别测定NT—proBNP水平及LVEF。结果左束支组QRS波时限长于右束支组；左束

2、支组、右束支组NT—proBNP水平明显高于对照组，LVEF低于对照组；左束支组NT—proBNP高于右束支组，LVEF低于右束支组；差异有统计学意义<0．05)。左束支型QRS波时限延长与血浆NT—proBNP水平呈正相关，与LVEF呈负相关。而右束支组QRS波时限延长与血浆NT—proBNP水平呈正相关，与LVEF无明显相关。结论左束支阻滞的QRS波时限延长与左室收缩功能下降及血浆NT—proBNP水平相关性良好，可以作为临床判断心力衰竭程度的一个简便指标。【关键词】QRS波时限；心力衰竭；脑钠肽；左柬支传导阻滞；右柬支传导阻滞Re

3、lativitybetweendifferenttypesofQRScomplexdurationandheartfailureZHAOJie-ping,CUITian—xiang,FangHui—ling．DepartmentofCardiology,HenanChestHospital,Zhengzhou450008,China【Abstract】ObjectiveToinvestigatetherelativityofdifferenttypesofQRScomplexduration(QRSd)，N—terminalprobra

4、innatriureticpeptide(NT-proBNP)andleftventricularejectionfraction(LVEF)．MetllodsTherewere97patientsofchronicheartfailurewithprolongedQRSdgreaterthan120msdividedintotwogroups．AccordingtotheclinictypesofQRSd，Therewere47casesintheleftbundlebranchblockgroup(LBBB)and50casesin

5、thefightbundlebranchblockgroup(RBBB)．Atotalof40caseswithoutchronicheartfailureandunnormalQRScomplexdurationweresetasthecontrolgroup．ThelevelofNT-proBNPandLVEFweremeasured．ResultsTheQRSdofLBBBwaslongerthanthatofRBBB．ThelevelofNT-proBNPofbothLBBBandRBBBwerehigherthanthatof

6、thecontrolgroup，whiletheirLVEFwerelowerthanthatofthecontrolgroup．TheNT—proBNPofLBBBwafthigherthanRBBB，anditsLVEFwaslowerthanRBBB．Thesediferenceswerestatisticallysignificant(P

7、VEF．TheprolongedQRSdinRBBBWaSpositivelycorelatedwithNT-proBNP，butwasnotcorrelatedwithLVEF．ConclusionQRSdofleftbundlebranchblockhasgoodrelativitywithLVEFandNT—proBNP，anditcanbeusedasasimpleindicatorofthelevelofheartfailure．【Keywords】QRScomplexduration；Heartfailure；Brainna

8、triureticpeptide；Leftbundlebranchblock；Rishtbundlebranchblock心力衰竭(心衰)是影响人类健康的主要疾病之一，有心律失常、急性或未纠正电解质紊乱、使