t-LBBB与慢性稳定型心力衰竭治疗效果的相关性分析

Correlation Analysis of t-LBBB and Treatment Effect of Chronic Stable Heart Failure

目的探究真性左束支传导阻滞(true left bundle branch block,t-LBBB)心电图特征与慢性稳定型心力衰竭治疗效果的相关性.方法选取该院2019年3月—2020年1月收治的92例慢性稳定型心力衰竭患者为研究对象,依据其心电图检查结果,分为对照组[35例,非t-LBBB(nt-LBBB)]、观察组(57例,t-LBBB),两组均接受心脏再同步化治疗,治疗后持续随访1年.比较两组患者治疗前及末次随访时的心功能指标[美国纽约心脏病学会(New York Heart Association,NYHA)心功能分级、左室舒张末期内径(left ventricular end diastolic diameter,LVEDd)、左室射血分数(left ventricular ejection fraction,LVEF)、QRS波宽]、末次随访术后应答情况,分析t-LBBB心电图特征与慢性稳定型心力衰竭手术应答之间相关性.结果两组患者治疗前的NYHA、LVEDd、LVEF、QRS波宽水平比较,差异无统计学意义(P>0.05);末次随访时,观察组的NYHA、LVEDd、QRS波宽水平均低于对照组,LVEF水平高于对照组,组间差异有统计学意义(P<0.05).观察组手术应答率为94.74%,高于对照组的74.29%,差异有统计学意义(P<0.05).经Spearman相关性分析,t-LBBB与患者心脏再同步化治疗呈正相关(r=0.758,P<0.05).结论存在t-LBBB心电图特征的慢性稳定性心力衰竭患者,心脏再同步化治疗的结局更为理想.

Objective To investigate the correlation between electrocardiogram(ECG)characteristics of true left bundle branch block(t-LBBB)and the therapeutic effect of chronic stable heart failure.Methods A total of 92 patients with chronic stable heart failure admitted to the hospital from March 2019 to January 2020 were selected as the study subjects.According to the electrocardiogram examination results,they were divided into a control group[35 cases,non-T-LBBB(NTLBBB)]and an observation group(57 cases,T-LBBB).Both groups received cardiac resynchronization treatment and were followed up for 1 year after treatment.Cardiac function indexes of the two groups were compared before treatment and at the last follow-up[New York Heart Association(NYHA)cardiac function grading,left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)and QRS wave width],and postoperative response at the last follow-up were analyzed,the correlation between the ecg characteristics of T-LBBB and the surgical response in chronic stable heart failure was analyzed.Results There were no significant differences in NYHA,LVEDd,LVEF and QRS wave width between the two groups before treatment(P>0.05);at the last follow-up,the NYHA,LVEDd and QRS wave width in the observation group were lower than those in the control group,while the LVEF level was higher than that in the control group,the differences between the groups were statistically significant(P<0.05).The operation response rate of the observation group was 94.74%,higher than 74.29%of the control group,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that t-LBBB was positively correlated with cardiac resynchronization therapy(r=0.758,P<0.05).Conclusion The outcome of cardiac resynchronization therapy is better in patients with chronic stable heart failure with T-LBBB ecg characteristics.