不同类型的QRS波增宽与心力衰竭的相关性

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＆gt;120 ms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（P＆lt;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。

Relativity between different types of QRS complex duration and heart failure

Objective To investigate the relativity of different types of QRS complex duration （QRSd）, N-terminal pro brain natriuretic peptide （NT-proBNP） and left ventricular ejection fraction （LVEF）. Methods There were 97 patients of chronic heart failure with prolonged QRSd greater than 120 ms divided into two groups. According to the clinic types of QRSd, There were 47 cases in the left bundle branch block group （LBBB） and 50 cases in the right bundle branch block group （RBBB）. A total of 40 cases without chronic heart failure and unnormal QRS complex duration were set as the control group. The level of NT-proBNP and LVEF were measured. Results The QRSd of LBBB was longer than that of RBBB. The level of NT-proBNP of both LBBB and RBBB were higher than that of the control group, while their LVEF were lower than that of the control group. The NT-proBNP of LBBB was higher than RBBB, and its LVEF was lower than RBBB. These differences were statistically significant （P＆lt;0.05）. The prolonged QRSd in LBBB was positively correlated with NT-proBNP, and was negatively correlated with LVEF. The prolonged QRSd in RBBB was positively correlated with NT-proBNP, but was not correlated with LVEF. Conclusion QRSd of left bundle branch block has good relativity with LVEF and NT-proBNP, and it can be used as a simple indicator of the level of heart failure.