静息性心电图QRS波持续时间与突发心脏病猝死的相关性研究

Correlation study between the duration time of QRS wave in resting electrocardiogram and sudden cardiac death

目的研究静息性心电图的QRS波持续时间与突发心脏病猝死(SCD)的相关性。方法收集我院2016年2月至2017年2月收治的心内科患者及健康体检者共1 000例的临床资料,研究对象均行静息12导联心电图检查,随访12个月观察是否发生SCD,根据心电图检测结果分成QRS波<110 ms组(n=819)和QRS波≥110 ms组(n=181);根据随访结果分成猝死组(n=77)和对照组(n=923)。收集整理1 000例研究对象的临床资料,整理后进行统计学分析。结果不同QRS波持续时间的受检对象的性别、年龄差异不显著(P>0.05);QRS波≥110 ms组受检对象的高血压、糖尿病、高血脂、冠心病、慢性心力衰竭、哮喘的发病率以及心功能分级均高于QRS波<110 ms组(P<0.05);且QRS波≥110 ms组受检对象随访12个月的SCD率明显高于QRS波<110 ms组(P<0.05);猝死组的QRS波持续时间长于对照组,QRS波≥120 ms比例高于对照组(P<0.05);猝死组与对照组的QRS波的波形差异不显著(P>0.05)。结论静息性心电图QRS波持续时间与SCD之间呈正相关关系,加强对心内科患者以及高危心脏病人群的心电图QRS波持续时间的监测有助于临床医师预测SCD的风险。

Objective To study the correlation between the duration time of QRS wave in resting electrocardiogram andsudden cardiac death （SCD）. Methods The clinical data of 1 000 cases of patients and healthy subjects admitted in thecardiology department in our hospital from February 2016 to February 2017, all the subjects underwent resting 12 leadelectrocardiogram and were followed up for 12 months to observe the incidence of SCD. According to the results ofelectrocardiogram, subjects were divided into QRS wave 〈110 ms group （n=819） and QRS wave ≥ 110 ms group （n=181）, and were divided into sudden death group （n=77） and control group （n=923） according to the follow-up results.The clinical data of 1 000 subjects were collected and analyzed statistically. Results There were no significant differencesbetween subjects with different duration time of QRS in the gender and age （P〉0.05）. The incidences of hypertension,diabetes, hyperlipidemia, coronary heart disease, chronic heart failure, asthma and heart function classification in theQRS wave≥110 ms group were higher than those of the QRS wave 〈110 ms group （P〈0.05）; the SCD rate in the QRSwave≥110 ms group was significantly higher than that of the QRS wave 〈110 ms group followed up for 12 months（P 〈0.05）; the duration time of QRS of the sudden death group was longer than that in the control group, and theincidence of QRS wave≥120 ms in the sudden death group was higher than that in the control group （P〈0.05）. Therewas no significant difference in QRS waveform between the sudden death group and the control group （P 〉0.05）.Conclusion There is a positive correlation between the duration of QRS in resting electrocardiogram and SCD. Monitoringof the duration of electrocardiographic QRS in patients with cardiology and high-risk heart disease can help clinicianspredict SCD.