早期心电图QRS波时限与老年急性冠脉综合征患者左心功能的相关性分析

Correlation of Early Electrocardiogram QRS Duration and Left Heart Function in Elderly Patients with Acute Coronary Syndrome

目的:探讨老年急性冠脉综合征患者(ACS)患者入院时心电图QRS波时限与左心功能的相关性。方法:选取396例老年ACS患者为研究对象,测定所有患者入院时的体表心电图的QRS波时限,按照QRS时限将患者将患者分为Ⅰ组:60 ms≤QRS时限≤80 ms、Ⅱ组:80 ms<QRS时限<100 ms、Ⅲ组:QRS时限≥100 ms;检测各组患者相关心脏超声心功能指标,同时检测入院时肌钙蛋白I(c Tn I)、肌酸激酶同工酶(CK-MB)、血清B型脑钠肽(BNP);记录患者住院期间发生左心衰竭情况。结果:与Ⅰ组及Ⅱ组比较,Ⅲ组的BNP及c Tn I明显升高(P<0.05)、LVEF降低(P<0.05);血清BNP与QRS时限呈正相关(P<0.05),而LVEF与QRS时限呈负相关(P<0.05);QRSw时限延长是老年ACS患者发生左心衰竭的独立危险因素(OR=1.214,P<0.05)。结论:老年ACS患者QRS时限延长与左心功能下降密切相关,可能是老年ACS患者发生左心衰竭的独立危险因素。

To investigate the correlation of early electrocardiogram QRS duration and left heart function in elderly patients with acute coronary syndrome（ACS）. Methods： A total of 396 cases of elderly patients with ACS were selected as the research subjects. Their body surface electrocardiogram QRS duration was detected when they were admitted in hospital. Then according to their QRS duration, they were divided into three groups： groupsⅠ（60 ms ≤QRS ≤80 ms）, groupsⅡ（80 ms QRS 100 ms）, groups Ⅲ（QRS ≥100 ms）. We detected the related echocardiographic heart function index of all patients, at the same time detected the levels of troponin I（c Tn I）, creatine kinase isoenzyme（CK-MB）, serum b-type brain natriuretic peptide（BNP）, and recorded the left heart failure occurrence during hospitalization. Results： Compared with group Ⅰ and Ⅱ, the BNP and c Tn I levels of group Ⅲ was obviously increased（P〈0.05）, but the LVEF was decreased（P〈0.05）. The QRS duration was positively correlated with serum BNP（P〈0.05）, but negatively correlated with LVEF（P〈0.05）. The eventually QRSw duration was the independent risk factor for left heart failure of elderly patients with ACS（OR = 1.214, P〈0.05）. Conclusion： QRS duration extension was closely related to the fall in the left heart function,and might be the independent risk factor for left heart failure in elderly patients with ACS.