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目的探讨左束支阻滞(left bundle branch block,LBBB)合并心功能不全患者QRS波时限与心功能的关系。方法分析120例LBBB合并心功能不全患者的临床资料,根据QRS波时限分成A组、B组、C组3组,比较3组血浆NT-proBNP水平、心功能NYHA分级,左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)。结果 A、B、C组三组NT-proBNP水平逐渐增高,各组间比较差异有显著意义。A组心功能Ⅱ级患者比例明显高于B、C组,差异有显著意义;B组、C组心功能Ⅳ患者比例明显高于A组,差异有显著意义。B、C组患者EDV和ESV值明显高于A组患者,差异有显著意义,B组、C组患者EF值明显低于A组患者,差异有显著意义。C组患者EDV和ESV值有低于B组患者的趋势,C组患者EF值有高于B组患者的趋势,但均无统计学意义。结论 LBBB伴心功能不全时,QRS时限可以反映LBBB合并心功能不全患者心脏病变严重程度,和患者NT-proBNP浓度、LVEDV值、LVESV值、LVEF值具有一定的相关性。
Objective To investigate the relationship between QRS wave duration and cardiac function in patients with left bundle branch block (LBBB) complicated with cardiac insufficiency. Methods The clinical data of 120 patients with LBBB complicated with cardiac insufficiency were analyzed. According to the QRS wave time limit, the patients were divided into three groups: group A, group B and group C. The levels of NT-proBNP, NYHA classification, left ventricular end-diastolic volume LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF). Results The levels of NT-proBNP in groups A, B and C increased gradually, and the differences among groups were significant. The proportion of patients with grade Ⅱ cardiac function in group A was significantly higher than those in group B and C, and the difference was significant. The proportion of patients with cardiac function Ⅳ in group B and C was significantly higher than that in group A, the difference was significant. In group B and group C, EDV and ESV were significantly higher than those in group A, the difference was significant. The EF in group B and group C was significantly lower than that in group A, the difference was significant. The EDV and ESV in group C were lower than those in group B. The EF in group C was higher than that in group B, but there was no statistical significance. Conclusions When LBBB with cardiac insufficiency, QRS duration can reflect the severity of heart disease in patients with LBBB complicated with heart failure, and has some correlation with NT-proBNP concentration, LVEDV, LVESV and LVEF.