QRS波群时限及血浆BNP与慢性心力衰竭致心源性猝死的相关性研究
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摘要
目的:探究QRS波群时限和血浆脑钠肽(BNP)与慢性心力衰竭(chronic heart failure,CHF)导致心源性猝死(sudden cardiac death,SCD)的相关性。方法:选择本院接受治疗的CHF病患258例,并记为观察组。随机选取同期进行健康体检的志愿者250例,记为对照组。对所有病患进行基本资料记录,对比两组的LVEF、左室舒张末期内径、QRS波群时限以及BNP。结果:观察组出现高血压、高血脂、糖尿病、DCM以及ICM的比例更大,LVEF更低,并且左室舒张末期内径、QRS波群时限以及BNP更大,差异均有统计学意义(P<0.05);在所有CHF中,SCD病患占10.47%(27/278)。根据Logistic回归性分析得到CHF导致SCD的4个相关因素,即:LVEF、左室舒张末期内径、QRS波群时限以及BNP等。结论:CHF病患存在高血压、高血脂等危险因素,并且当CHF病患QRS波群时限和血浆BNP增大时提示SCD出现的风险大。
Objective:To explore the correlation between QRS complex duration and brain natriuretic peptide(BNP)and occurrence of sudden cardiac death(SCD)in chronic heart failure(CHF).Methods:A total of 258 patients with CHF treated in this hospital were selected as the observation group.250 volunteers who received the health examination over the same period were randomly selected as the control group.The basic data of all patients was recorded.Then compared LVEF,left ventricular end-diastolic diameter,QRS complex duration and BNP between two groups.Results:The proportion of hypertension,hyperlipidemia,diabetes,DCM and ICM was higher in the observation group,while LVEF was lower and left ventricular end-diastolic diameter,QRS complex duration and BNP were higher than those in the control group.Patients with SCD occupied 10.47%(27/278)of all patients with CHF.According to the logistic regression analysis,it obtained 4related factors for SCD in patients with CHF,namely LVEF,left ventricular end-diastolic diameter,QRS complex duration and BNP,with the statistical difference between two groups(P<0.05).Conclusion:Patients with CHF may have the dangerous factors of hypertension and hyperlipidemia.In addition,the increase of QRS complex duration and plasma BNP indicate high risk of SCD for patients with CHF.
Objective:To explore the correlation between QRS complex duration and brain natriuretic peptide(BNP)and occurrence of sudden cardiac death(SCD)in chronic heart failure(CHF).Methods:A total of 258 patients with CHF treated in this hospital were selected as the observation group.250 volunteers who received the health examination over the same period were randomly selected as the control group.The basic data of all patients was recorded.Then compared LVEF,left ventricular end-diastolic diameter,QRS complex duration and BNP between two groups.Results:The proportion of hypertension,hyperlipidemia,diabetes,DCM and ICM was higher in the observation group,while LVEF was lower and left ventricular end-diastolic diameter,QRS complex duration and BNP were higher than those in the control group.Patients with SCD occupied 10.47%(27/278)of all patients with CHF.According to the logistic regression analysis,it obtained 4related factors for SCD in patients with CHF,namely LVEF,left ventricular end-diastolic diameter,QRS complex duration and BNP,with the statistical difference between two groups(P<0.05).Conclusion:Patients with CHF may have the dangerous factors of hypertension and hyperlipidemia.In addition,the increase of QRS complex duration and plasma BNP indicate high risk of SCD for patients with CHF.
引文
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3 宫姝宁,朴商,王玉红,等.N-端脑钠肽前体测定对慢性阻塞性肺疾病及肺心病患者右心功能的评估价值[J].中华肺部疾病杂志(电子版),2014,7(2):66-67.
4 蓝云锋,李泱.Omega-3多不饱和脂肪酸抗心律失常作用及其机制研究进展[J].中华老年多器官疾病杂志,2014,1(4):304-308.
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7 沈波,聂宇昕,刘中华,等.维持性血液透析患者血浆氨基端脑钠肽前体水平及相关分析[J].中华肾脏病杂志,2014,30(8):586-591.
8 舒燕,姜荣建,孔洪,等.老年心力衰竭患者心功能与血浆B型钠尿肽和尿酸的相关性研究[J].中华老年心脑血管病杂志,2014,1(10):1041-1043.
9 单爱军,王进,杜波,等.院内心源性猝死预后影响因素分析[J].中华急诊医学杂志,2013,23(10):1155-1158.
10 邵春丽,楚建民,朱俊,等.QRS波群"窄而高"的早期复极综合征患者反复发生心室颤动一例[J].中华心血管病杂志,2013,41(12):1061-1062.
11 杨广,明蕾,侯悦丽,程文娟,李向东.慢性心力衰竭患者aVR QRS电压影响因素分析[J].中国全科医学,2015,18(8):957-959.
12 祁巍,罗仁.心电图QRS波群时限与慢性心力衰竭患者心功能的相关性研究[J].实用心脑肺血管病杂志,2012,20(11):1828.
13 陈强,赵海燕.BNP及NT-proBNP在小儿心力衰竭诊断中的应用[J].中华妇幼临床医学杂志(电子版),2014,10(1):120-122.
14 齐斌,任威,李春江,张锐.血尿酸和氨基末端脑钠肽前体在急性心力衰竭中的诊断和预后预测价值[J].临床误诊误治,2013,26(3):72-74.
15 韩琳,赵祥海,吴宜鸣.心功能Ⅲ、Ⅳ级慢性心衰患者血清CA125与NT Pro-BNP浓度相关性研究[J].川北医学院学报,2014,(5):489-491.
16 霍志成,王智明,黄建中.N末端原脑利钠肽测定在慢性心力衰竭患者中的价值研究[J].实用心脑肺血管病杂志,2011,19(7):1131.
17 郭伟,方俊梅.血浆脑利钠肽在不完全型川崎病患儿诊断中的临床意义[J].中华危重症医学杂志(电子版),2014,7(3):202-204.
2 郑小菊,王继征,赵鹏,等.致心律失常性右心室心肌病与心源性猝死[J].中华临床医师杂志(电子版),2013,1(18):8349-8352.
3 宫姝宁,朴商,王玉红,等.N-端脑钠肽前体测定对慢性阻塞性肺疾病及肺心病患者右心功能的评估价值[J].中华肺部疾病杂志(电子版),2014,7(2):66-67.
4 蓝云锋,李泱.Omega-3多不饱和脂肪酸抗心律失常作用及其机制研究进展[J].中华老年多器官疾病杂志,2014,1(4):304-308.
5 孟哲颖,申锷.超声心动图及其新技术评价心肌致密化不全的研究进展[J].中华医学超声杂志(电子版),2013,1(11):888-893.
6 Laukkanen JA,Di Angelantonio E,Khan H,et al.T-wave inversion,QRS duration,and QRS/T angle as electrocardiographic predictors of the risk for sudden cardiac death.[J].Am J Cardiol,2014,113(7):1178-1183.
7 沈波,聂宇昕,刘中华,等.维持性血液透析患者血浆氨基端脑钠肽前体水平及相关分析[J].中华肾脏病杂志,2014,30(8):586-591.
8 舒燕,姜荣建,孔洪,等.老年心力衰竭患者心功能与血浆B型钠尿肽和尿酸的相关性研究[J].中华老年心脑血管病杂志,2014,1(10):1041-1043.
9 单爱军,王进,杜波,等.院内心源性猝死预后影响因素分析[J].中华急诊医学杂志,2013,23(10):1155-1158.
10 邵春丽,楚建民,朱俊,等.QRS波群"窄而高"的早期复极综合征患者反复发生心室颤动一例[J].中华心血管病杂志,2013,41(12):1061-1062.
11 杨广,明蕾,侯悦丽,程文娟,李向东.慢性心力衰竭患者aVR QRS电压影响因素分析[J].中国全科医学,2015,18(8):957-959.
12 祁巍,罗仁.心电图QRS波群时限与慢性心力衰竭患者心功能的相关性研究[J].实用心脑肺血管病杂志,2012,20(11):1828.
13 陈强,赵海燕.BNP及NT-proBNP在小儿心力衰竭诊断中的应用[J].中华妇幼临床医学杂志(电子版),2014,10(1):120-122.
14 齐斌,任威,李春江,张锐.血尿酸和氨基末端脑钠肽前体在急性心力衰竭中的诊断和预后预测价值[J].临床误诊误治,2013,26(3):72-74.
15 韩琳,赵祥海,吴宜鸣.心功能Ⅲ、Ⅳ级慢性心衰患者血清CA125与NT Pro-BNP浓度相关性研究[J].川北医学院学报,2014,(5):489-491.
16 霍志成,王智明,黄建中.N末端原脑利钠肽测定在慢性心力衰竭患者中的价值研究[J].实用心脑肺血管病杂志,2011,19(7):1131.
17 郭伟,方俊梅.血浆脑利钠肽在不完全型川崎病患儿诊断中的临床意义[J].中华危重症医学杂志(电子版),2014,7(3):202-204.