QRS波时限对慢性心力衰竭患者的预测价值

QRS complex duration as a prognosis predictor for heart failure patients

目的评价慢性充血性心力衰竭患者出现QRS波时限延长的意义。方法回顾性分析2006年1月至2007年3月北京大学人民医院心内科普通病房住院的慢性充血性心力衰竭患者共97例,收集其心电图及超声心动图资料。结果慢性充血性心力衰竭患者(1)QRS波时限延长与左心房内径无关[(4.55±1.539)cm比(4.50±0.760)cm,P=0.845];(2)与QRS波时限<120ms组相比,QRS波时限≥120ms组左心室舒张末内径明显增大[(5.83±1.05)cm比(6.73±1.478)cm,P=0.001];(3)QRS波时限与二尖瓣反流情况无明显相关性(P=0.365);(4)QRS波时限与左心室射血分数相关,与QRS波时限<120ms组相比,QRS波时限≥120ms组左心室射血分数显著降低[(51.0±15.7)%比(39.0±15.7)%,P=0.0001];QRS波时限与NYHA分级具有一定的相关性(P=0.04);(5)QRS波时限与死亡率无明显相关性(P=0.251)。结论心电图作为一种简单、实用、经济的检查手段,有助于识别高危的心力衰竭患者进行进一步评价。

Objective To assess the significance of QRS prolongation（ ≥ 120 ms） in patients with chronic congestive heart failure. Methods Ninty-seven patients with chronic congestive heart failure in Peking University People＇s Hospital from January 2006 to March 2007 were analyzed retrospectively. Results To chronic heart failure patients ： （ 1 ） left atrial diameter is independent of QRS duration [ （4. 55 ± 1. 539） cm vs. （4.50 ± 0. 760） cm, P = 0. 845 ] ; （ 2 ） prolongation of QRS duration is correlating to left ventricular end-diastolic diameter compared with narrow QRS duration [ （ 5.83 ± 1.05 ） cm vs. （6. 73 ± 1. 478） cm, P = 0. 001 ] ; （ 3 ） QRS duration is independent with mitral regurgitation （ P = 0. 365 ） ; （ 4 ） prolagatien of QRS duration is associated with lower left ventricular ejection fi＇action compared with normal QRS duration [（ 51.0 ± 15.7 ） % vs. （ 39. 0 ± 15.7 ） %, P = 0. 0001] ; QRS duration has some relationship with NYHA classification relatively （P = 0. 04 ） ;（5 ）there is no relation between QRS duration and mortality （ P = 0. 251 ）. Conclusion Electrocardiogram can be a useful predictor for heart failure patients in high risk.