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目的:分析急性心肌梗死后心力衰竭患者血浆脑钠肽(BNP)与QTc间期关系及两者共同对急性心肌梗死预后的影响。方法:选择商丘市第一人民医院急性心肌梗死患者58例,分别测定BNP值将患者分为<500pg/mL组,500～999pg/mL组,1 000～1 999pg/mL组,>2 000pg/mL组。12导同步心电图自动测算QTc间期,同时人工测量QT间期离散度,比较4组间差异。采用秩相关分析脑钠肽质量浓度与心脏左室舒张末期容积,左室射血分数值,QTc间期和QT间期离散度(QTd)的关系。结果:①随着脑钠肽质量浓度的增加,QTc间期也随之增宽,<500pg/mL组QTc间期比其他3组窄,有统计学意义(P<0.01);而QTd只显示>2 000pb/mL与<500pg/mL组有统计学差异(P<0.01)。②秩相关分析示脑钠肽质量浓度,左心室舒张末期直径与QTc间期呈直线正相关(P<0.05～0.01)。QTc间期和QTd呈直线正相关(P<0.01)。结论:急性心肌梗死患者脑钠肽质量浓度与QTc间期有很好的相关性,两者联合应用有助于急性心肌梗死患者预后危险程度分层。
Objective: To analyze the relationship between plasma brain natriuretic peptide (BNP) and QTc in patients with heart failure and their prognosis after acute myocardial infarction. Methods: Fifty-eight patients with acute myocardial infarction in Shangqiu First People’s Hospital were enrolled in this study. Patients were divided into five groups: 500pg / mL group, 500-999pg / mL group, 1000-1999pg / mL group,> 2000pg / mL group. The 12-lead synchronous ECG automatically measured the QTc interval, meanwhile, the QT interval dispersion was measured manually to compare the differences among the 4 groups. The rank correlation analysis of brain natriuretic peptide concentration and left ventricular end-diastolic volume, left ventricular ejection fraction, QTc interval and QT interval dispersion (QTd) relationship. Results: ①With the increase of brain natriuretic peptide concentration, the QTc interval also broadened. The QTc interval of <500pg / mL group was narrower than the other 3 groups (P <0.01), while the QTd showed only > 2 000 pb / mL and <500 pg / mL groups were statistically different (P <0.01). (2) The rank correlation analysis showed a positive linear correlation between brain natriuretic peptide concentration and left ventricular end-diastolic diameter and QTc interval (P <0.05 ~ 0.01). There was a linear positive correlation between QTc interval and QTd (P <0.01). Conclusion: The concentration of brain natriuretic peptide in patients with acute myocardial infarction has a good correlation with QTc interval. The combination of the two can contribute to the stratification of the prognosis of patients with acute myocardial infarction.