碎片状QRS波与高血压患者室性心律失常发生的关系研究

Relationship between Fragmented QRS Waves and Ventricular Arrhythmia in Patients with Hypertension

背景高血压患者室性心律失常的发生率近年来不断增高,但目前仍无有效的预测指标。目的分析碎片状QRS波与高血压患者室性心律失常发生的关系。方法选取2017年6月—2019年6月于西安医学院第二附属医院就诊的高血压患者246例,根据心电图将发生室性心律失常患者分为试验组(n=62),未发生室性心律失常患者为对照组(n=184)。比较两组患者一般资料、高血压分级、实验室检查指标、心电图特征(包括有无P波缩短、PR间期异常、碎片状QRS波、QRS波延长和ST段异常),采用多因素Cox风险比例回归分析碎片状QRS波与高血压患者室性心律失常发生的关系。结果两组患者有无P波缩短、PR间期异常、QRS波延长、ST段异常比较,差异无统计学意义(P>0.05),试验组患者碎片状QRS波发生率高于对照组(P<0.05)。多因素Cox风险比例回归分析结果显示,碎片状QRS波是高血压患者室性心律失常发生的影响因素〔HR=3.431,95%CI(1.502,7.835),P<0.05〕。结论碎片状QRS波是高血压患者室性心律失常的影响因素,可于临床上对高血压患者室性心律失常的风险进行预测。

Background In recent years,the incidence of ventricular arrhythmia in patients with hypertension has been increasing,but there is no effective predictor.Objective To analysis the relationship between fragmented QRS waves and ventricular arrhythmia in patients with hypertension.Methods A total of 246 hypertensive patients were admitted to Second Affiliated Hospital of Xi'an Medical College from June 2017 to June 2019,they were divided into experimental groups(heppened ventricular arrhythmia,n=62)and control group(no ventricular arrhythmia,n=184)according to electrocardiogram.General data,hypertension grade,laboratory examination index and ECG characteristics(including P-wave shortening,PR interval abnormality,fragmentary QRS wave,QRS wave prolongation and ST segment abnormality)compared between the two groups.Multivariate Cox risk ratio regression was used to analyze the relationship between fragmented QRS and ventricular arrhythmia in hypertensive with patients.Results There was no statistically significant difference in P-wave shortening,PR interval abnormality,QRS wave extension or ST segment abnormalities between the two groups(P>0.05),but the incidence of fragmentary QRS wave in experimental groups was higher than that in control group(P<0.05).Multivariate Cox risk ratio regression analysis showed that,fragmentary QRS wave was independent influencing factors of ventricular arrhythmia in patients with hypertension〔HR=3.431,95%CI(1.502,7.835),P<0.05〕.Conclusion Fragmented QRS waves have a significant correlation with the risk of ventricular arrhythmia in patients with hypertension,and can be used to predict the risk of ventricular arrhythmia in patients with hypertension.