碎裂QRS与特发性扩张型心肌病预后关系研究

Relationship between fragmented QRS and the prognosis of idiopathic dilated cardiomyopathy

目的探讨碎裂ORS与特发性扩张型心肌病患者预后的关系。方法85例特发性扩张型心肌病患者根据常规心电图检查结果分为碎裂QRS组41例和非碎裂QRS组44例，随访2～33（16．5士9．4）个月，比较2组患者全因病死率和室性心律失常发生率。结果8例死亡，5例室性心律失常；碎裂QRS组全因病死率和室性心律失常发生率高于非碎裂QRS组（P〈0．05）；Kaplan-Meier生存分析碎裂QRS组生存率低于非碎裂QRS组（P〈0．05）；多变量C0z回归分析显示，碎裂QRS是特发性扩张型心肌病全因死亡和室性心律失常的预测因子（OR=1．182，95％CI：1．036～2．910，P=0．038）。结论碎裂QRS与特发性扩张型心肌病的不良预后有关，碎裂QRS对特发性扩张型心肌病患者全因死亡和室性心律失常有较高预测价值。

Objective To explore the relationship between fragmented QRS and the prognosis of idiopathic dilated cardiomyopathy. Methods Eighty-five patients with idiopathic dilated cardiomyopathy were divided into fragmented QRS group and non-fragmented QRS group according to conventional ECG results. All patients were followed up for 2 to 33 （16. 5±9. 4） months. The all-cause fatality rate and ventricular arrhythmia incidence were observed and compared between two groups. Results Eight patients died and 5 patients had ventricular arrhythmia. All-cause fatality rate and the incidence of ventricular arrhythmia were higher in fragmented QRS group than those in non-fragmentated QRS group. KaplarrMeier survival analysis revealed the survival rate was lower in fragmented QRS group than that in non-fragmented QRS group. Multivariate Coa： regression analysis suggested fragmented QRS was a predictor for all-cause death and ventricular arrhythmia in patients with idiopathic dilated cardiomyopathy. Conclusions Fragmented QRS is associated with poor prognosis of idiopathic dilated cardiomyopathy, and has a high predictive value to all-cause fatality rate and ventricular arrhythmia in patients with idiopathic dilated cardiomyopathy.