H型高血压合并射血分数保留心衰患者心脏超声、动态心电图及BNP变化分析  

Analysis for the changes of echocardiography,electrocardiogram and BNP in patients with H-type hypertension complicated by ejection fraction retained heart failure retained ejection fraction

作　　者：宋婷婷[1] 刘丽[1] 付志强[2] 贾红丹[1] 李敏[1] SONG Tingting;LIU Li;FU Zhiqiang(Deparment of Vasculocardiology,The First Hospital of Qinhuangdao City,Hebei,Qinhuangdao 066000,China;不详)

机构地区：[1]河北省秦皇岛市第一医院心血管内科,066000 [2]河北省秦皇岛市第一医院耳鼻咽喉科,066000

出　　处：《河北医药》2020年第20期3120-3122,3126,共4页Hebei Medical Journal

基　　金：秦皇岛市重点研发计划科技支撑项目(编号:201805A046)。

摘　　要：目的研究H型高血压合并射血分数保留心衰(HFPEF)患者心脏超声、动态心电图及B型脑钠肽(BNP)变化。方法纳入2017年1月至2019年5月收治的H型高血压合并HFPEF患者200例进行该研究,记作病变组。另取同期收治的H型高血压200例作为对照组。对所有人员均进行心脏超声以及动态心电图检查,并比较上述相关指标水平,同时对比2组各项实验室指标水平。此外,分析病变组不同纽约心脏协会(NYHA)心功能患者的血浆BNP以及心脏超声、动态心电图指标水平。分析病变组不同NYHA心功能患者心律失常发生情况。结果病变组BNP水平显著高于对照组(P<0.05)。病变组LAD显著高于对照组,而E/A显著低于对照组(均P<0.05)。病变组QT间期、QTc间期、QTd均显著高于对照组(均P<0.05)。NYHA心功能Ⅱ级、Ⅲ级、Ⅳ级患者的血浆BNP以及LAD、QT间期、QTc间期、QTd均呈逐渐升高趋势,而E/A呈逐渐下降趋势,且经单因素方差分析可得:各级间上述各项指标对比差异有统计学意义(均P<0.05)。结论血浆BNP、心脏超声、动态心电图均对H型高血压合并HFPEF患者均有一定的诊断价值,可作为临床评价患者病情严重程度的有效手段。Objective To investigate the changes of echocardiography,electrocardiogram and B type brain natriuretic peptide(BNP)in patients with H-type hypertension complicated by ejection fraction retained heart failure(HFPEF).Methods A total of 200 patients with H type hypertension complicated by HFPEF who were admitted and treated in our hospital from January 2017 to May 2019 were enrolled as lesion group,at the same time,the other 200 patients with H type hypertension were enrolled as control group.The echocardiography and dynamic electrocardiogram were performed for all the subjects.The levels of the above indexes,and the levels of various laboratory indexes,plasma BNP,echocardiographic and dynamic electrocardiogram(DCG)levels according to the standard of New York heart association(NYHA)were observed and compared between the two groups.Moreover the incidence of arrhythmia in patients with different NYHA cardiac functions in lesion group was analyzed.Results The levels of BNP and LAD in lesion group were significantly higher than those in control group(P<0.05),however,the E/A ratio was significantly lower than that in control group(P<0.05).Moreover the QT interval,QTc interval and QTd in lesion group were significantly higher those in control group(P<0.05).The BNP levels and LAD,QT,QTc,QTd in patients with heart function NYHA classⅡ,Ⅲ,Ⅳshowed a trend of increasing gradually,but the E/A ratio showed a trend of dereasing graduall.The single factor analysis of variance showed that there were significant differences in the indexes mentioned above in patients with different heart function classes(P<0.05).Conclusion The plasma BNP,cardiac ultrasound and dynamic electrocardiogram have certain value in diagnosis of H type hypertension complicated by HFPEF,which can be regarded as an effective means to evaluate the severity of the disease.

关 键 词：H型高血压 射血分数保留心衰 心脏超声 动态心电图 B型脑钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]