肺源性心脏病QT离散度与心功能不全关系的研究

Relationship Between Q-T Dispersion and Cardiac insufficiency in Pulmonary Heart Disease

目的 探讨慢性肺源性心脏病 (PHD)病人心电图QT离散度 (QTd)与心功能不全 (CDF)的关系。方法 PHD病人 38例 ,按病情分为心功能不全Ⅰ级 12例 ,Ⅱ级 17例 ,Ⅲ级 9例。测量常规 12导联心电图QT ,并与对照组 30例进行比较。结果 CDF各级QTd、QTcd分别为Ⅰ级 5 2 .1± 12 .89ms,6 5 .1± 17.2 8ms;Ⅱ级 6 6 .2± 12 .8ms,76 .5± 2 0 .2ms ;Ⅲ级 88.8± 16 .6ms,116 .2± 19.1ms ;对照组为 31.9± 9.1ms,33.6± 10 .4ms,各组与对照组、各组之间比较均为P <0 .0 1。结论 慢性肺源性心脏病CDF早期 ,心电图QTd、QTcd显著增加 ,可作为肺源性心脏病早期诊断依据之一 ;QT越大 ,病情越重 ,预后越差 ,动态观察可判断病情、提示预后。

Objective To analyze the relationship between electrocardiogram (ECG) and cardiac insufficiency in chronic pulmonary heart disease (PHD). Methods 38 cases with PHD were divided into 3 groups according to the degree of cardiac insufficiency: class Ⅰ(n=12), class Ⅱ (n= 17), class Ⅲ (n=9). The routine 12-lead ECG was measured and compared with contrast group. Results QTd and QTcd was 52.1±12.89ms and 65.l±17.28ms(class Ⅰ),66.2±12.8ms and 76.5±20.2ms(class Ⅱ), 88.8±16.6ms and 116.2±19.1ms(class Ⅲ), 31.9±9.1ms and 33.6±10.4ms (control group) respectively. The difference among three groups and to control group was significant (P<0.01). Conclusions The increase of QTd and QTcd in ECG is one of diagnostic criterions of cardiac insufficiency. The larger the Qt was, the serious the state of illness was. And the patients have an unfavourable prognosis.