内科

目的探讨射血分数保留型心力衰竭（HFpEF）患者心电图QRS波时程、血清基质金属蛋白酶-2（MMP-2）水平及其临床意义。方法选取住院治疗的167例HFpEF患者作为观察组，选取同期167名健康体检者作为健康对照组。比较两组研究对象的心电图QRS波时程和血清MMP-2水平，以及不同心功能分级HFpEF患者的心电图QRS波时程、QRS波时程比值（TEF）和左室射血分数（LVEF），分析HFpEF患者心电图QRS波时程与TEF、LVEF、血清MMP-2水平的相关性。结果观察组患者的心电图QRS波时程、血清MMP-2水平长于或高于健康对照组（均P＜0.05）。随着其纽约心脏病协会心功能分级增加，HFpEF患者的心电图QRS波时程增加，TEF、LVEF均降低。Pearson相关性分析结果显示，HFpEF患者心电图QRS波时程和血清MMP-2水平呈正相关，和TEF、LVEF均呈负相关（均P＜0.05）。结论HFpEF患者心电图QRS波时程延长，血清MMP-2水平升高，心电图QRS波时程联合血清MMP-2水平检测或可用于HFpEF疾病评估，帮助临床预测病情严重程度。

ObjectiveTo investigate the Electrocardiographic(ECG) QRS duration and serum matrix metalloproteinase(MMP)-2 level and its clinical significance in patients with heart failure with preserved ejection fraction(HFpEF). MethodsA total of 167 hospitalized patients with HFpEF were selected as the observation group, and 167 healthy examinees in the same period were selected as the health control group. The ECG QRS duration and serum MMP-2 level of the two groups were compared, as well as the ECG QRS duration, QRS duration ratio（the value of LVEF divided by QRS duration time，TEF）and left ventricular ejection fraction (LVEF) of HFpEF patients with different cardiac function grades. The correlations between the ECG QRS duration and TEF, LVEF, serum MMP-2 level were analyzed. ResultsThe ECG QRS duration and serum MMP-2 level in the observation group were longer or higher than those in the healthy control group (all P＜0.05). With the increase of the New York Heart Association cardiac function grades, the ECG QRS duration in HFpEF patients increased, and TEF and LVEF decreased. Pearson correlation analysis results showed that the ECG QRS duration in HFpEF patients was positively correlated with their serum MMP-2 level and negatively correlated with their TEF and LVEF (all P＜0.05). ConclusionIn HFpEF patients, the ECG QRS duration is prolonged, and the serum MMP-2 level is increased. The detection of ECG QRS duration combined with the serum MMP-2 level may be helpful to the evaluation of HFpEF and clinical prediction of its severity.