慢性心力衰竭患者心电图QRS波时限特点及与预后关系分析

Characteristics of electrocardiogram QRS duration and its relationship with prognosis of patients with chronic heart failure

目的 慢性心力衰竭患者心电图QRS波时限的特点及和预后关系分析。方法 回顾性分析2020年6月至2021年5月首都医科大学附属北京积水潭医院收治的慢性心力衰竭患者共111例,设为观察组,观察组被进一步分为收缩性心力衰竭组(n=56)和舒张性心力衰竭组(n=55)。另选择同期健康体检人员109例为对照组。比较收缩性心力衰竭组与舒张性心力衰竭组一般资料情况,比较观察组与对照组心电图QRS波时限及振幅,比较收缩性心力衰竭组与舒张性心力衰竭组QRS波时限及振幅,统计1年后慢性心力衰竭患者预后良好及预后不良情况,采用多元Logistic回归分析影响慢性心力衰竭患者预后的危险因素。结果 观察组QRS波时限长于对照组,QRS振幅高于对照组,差异有统计学意义(P<0.05)。收缩性心力衰竭组QRS波时限长于舒张性心力衰竭组,QRS振幅高于舒张性心力衰竭组,差异有统计学意义(P<0.05)。预后良好组89例(80.18%),预后不良组22例(19.81%),2组与年龄、病程、疾病类型无关,差异无统计学意义(P>0.05),2组与合并高血压、合并糖尿病、有无吸烟史、NYHA分级、QRS波时限、QRS振幅有关,差异有统计学意义(P<0.05)。经多元Logistic回归分析显示,合并高血压、合并糖尿病、有无吸烟史、NYHA分级、QRS波时限、QRS振幅是影响慢性心力衰竭患者预后的独立危险因素(P<0.05)。结论 慢性心力衰竭患者心电图QRS时限延长,可能作为帮助诊断慢性心力衰竭疾病和评估病情严重程度的重要指标,可能是影响慢性心力衰竭患者预后的独立危险因素,但本文关于慢性心力衰竭患者QRS波时限研究,实验人员仅采纳本院慢性心力衰竭患者,存在一定局限性。

Objective To analyze the characteristics of electrocardiogram(ECG) QRS duration and its relationship with prognosis of patients with chronic heart failure(CHF).Methods A total of 111 CHF patients admitted to Beijing Jishuitan Hospital,Capital Medical University from June 2020 to May 2021 were retrospectively analyzed and enrolled as the observation group,and 109 healthy physical examination personnel during the same period were enrolled as the control group.Patients in the observation group were further assigned into systolic heart failure(SHF) subgroup(n=56) and diastolic heart failure(DHF) subgroup(n=55).The general data were compared between the two subgroups.The QRS duration and amplitudes were compared between the two subgroups,and between the observation group and control group.The prognosis of CHF patients were statistically analyzed after 1 year.Multiple Logistic regression was used to analyze the risk factors affecting the prognosis of CHF patients.Results The observation group had significantly longer QRS duration and significantly higher QRS amplitudes than the control group(P<0.05).The SHF subgroup had significantly longer QRS duration and significantly higher QRS amplitudes than the DHF subgroup(P<0.05).Among 111CHF patients,there were 89 cases(80.18 %) in the good prognosis group and 22 cases(19.81 %) in the poor prognosis group.There was no significant difference in age,course of disease and type of disease between groups(P>0.05).While,the difference in pooled hypertension or diabetes,having smoking history,New York Heart Association(NYHA) classification,QRS duration,and QRS amplitude was statistically significant between groups(P<0.05).Multiple Logistic regression analysis showed that pooled hypertension or diabetes,smoking history,NYHA classification,QRS duration and amplitude were independent risk factors affecting prognosis of CHF patients(P<0.05).Conclusion The prolonged ECG QRS duration in CHF patients may be an important indicator for diagnosing the disease and evaluating the condition,and it is an independent risk factor for patients prognosis.However,this study has certain limitations due to only focusing on CHF patients in our hospital.