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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-pro BNP)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-pro BNP水平,分析血浆NT-pro BNP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-pro BNP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-pro BNP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-pro BNP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-pro BNP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-pro BNP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。
Objective: To investigate the relationship between ECG QRS duration and plasma N-terminal pro-brain natriuretic peptide (NT-pro BNP) levels in patients with different types of heart failure and their clinical significance. Methods: A total of 300 patients with chronic heart failure were enrolled in our hospital from July 2012 to June 2014. The patients were divided into systolic heart failure group (S group) and diastolic heart failure group (D group) In addition, we selected 132 non-CHF patients in our hospital as the control group. All subjects were measured ECG QRS wave limit, and plasma levels of NT-pro BNP, plasma NT-pro BNP levels and QRS wave limits and NYHA functional classification. Results: Compared with the control group, the duration of QRS wave prolonged and the level of plasma NT-pro BNP was significantly increased in study group (P <0.05). The level of plasma NT-pro BNP in group S was significantly longer than that in group D In group D (P <0.05). There was a significant difference between the three NYHA classifications (P <0.05). The plasma levels of NT-pro BNP in patients in group S were positively correlated with the QRS wave limits and the NYHA functional class. Plasma NT-pro BNP There was no significant correlation between levels and QRS wave duration and NYHA functional class. Conclusion: It is clinically possible to diagnose the type of patients with chronic heart failure by combining the level of NT-pro BNP and the QRS wave duration to facilitate subsequent treatment.