慢性心力衰竭患者QRS时间延长的临床意义

Clinical Significance of QRS Prolongation in Patients with Chronic Heart Failure

目的评价慢性心力衰竭患者心电图QRS时间延长的临床意义。方法将入选的620例慢性心力衰竭患者按QRS时间分为≥120ms组（n=120）和〈120ms组（n=500），比较两组患者QRS时间与左心室射血分数（LVEF）、左心室短轴缩短分数（LVFS）、NYHA心功能分级、左心房左心室大小、二尖瓣反流、左心室壁厚度和住院死亡率。结果①≥120ms组QRS时间（143±21）ms，〈120ms组为（89±12）ms；②〈120ms组LVEF及LVFS分别为（47．02±16．13）％、（22.85±10．34）％，均较≥120ms组（37．00±13.91）％和（15．65±8．83）％大（P〈0．01）；⑨两组患者NYHA心功能分级差异无统计学意义（P〉0．05）；④≥120ms组左心房内径、左心室舒张末期内径较〈120ms组大（P〈005或001）；⑧≥120ms组二尖瓣反流率（82．1％）较〈120ms组（67．5％）高；⑧两组患者左心室壁厚度和住院死亡率差异均无统计学意义（P〉0.05）。结论心电图QRS时间可作为判断慢性心力衰竭患者病情的一项指标。

Objective To evaluate clinical significance of prolonged QRS duration in patients with chronic heart failure （CHF）. Methods 620 patients with CHF were divided into group A（QRS duration≥ 120ms, n=120） and group B（QRS duration〈120ms, n=500）. Left ventricutar ejection fraction（EF） and fractionat shortening（FS）, NYHA class, left ventricular and left atrial dimension, mitral regurgitation, left ventricular wall thickness and in-hospital mortality were compared between two groups. Results The QRS duration was （143 ± 21 ms） in group A and （89.0 ±12.0 ms） in group B. Left ventricular EF and FS were significantly lower [（37.00 ± 13.91 ）% ,（ 15.65 ±8.83）%] in group A than in group B [（47.02 ± 16.13）%, （22.85 ± 10.34）%] （P〈0.01）. Left atrial size and LV end-diastolic dimension were significantly greater in group A than in group B. The incidence of mitral regurgitation was higher in group A （82.1%） than in group B （67.5%）. While NYHA class, left ventricular wall thickness and in-hospital mortality were not significantly different between two groups. Conclusion Prolonged QRS duration reflects severity of CHF.