起搏QRS波时限与左心结构和功能的关系  

Relationships among paced QRS duration and left cardiac structures as well as function

作　　者：罗红[1] 李存仁[1] 刘志东[1] 李雪峰[1] 刘丽媚[1] 何雪波[1] 

机构地区：[1]梅州市人民医院内科,广东梅州514031

出　　处：《热带医学杂志》2011年第8期901-904,共4页Journal of Tropical Medicine

摘　　要：目的探讨长期右室心尖起搏患者的起搏QRS时限与左心结构、左心室收缩功能及心室间不同步的关系。方法长期右室心尖部起搏患者共105例,通过常规体表心电图测得起搏QRS(pQRS)时限,运用常规心脏超声心动图检测主动脉根部内径(AO)、左房内径(LAD)、收缩末期左心室内径(LVDs)、舒张末期左心室内径(LVDd)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)及左室射血分数(LVEF),分析pQRS时限与以上各心超指标的关系。结果 pQRS时限与LVDd、LVDs及IVST呈正相关(r分别为0.334、0.385和0.289,前两者P<0.01,后者P<0.05),与LVEF负相关(r=-0.312,P<0.05);pQRS时限与LAD的相关性更显著(r=0.595,P<0.01)。以pQRS时限≥180ms诊断左房扩大时,敏感度和特异度分别为86.49%和67.74%。结论对于长期右室心尖部起搏的患者,pQRS时限与左心大小及左心室收缩功能相关;pQRS时限延长(≥180ms),提示左心房扩大。Objective To investigate the relationships among the paced QRS （pQRS） duration and left cardiac structures,left ventricular （LV） systolic function as well as interventricular dyssynchrony in of patients with chronic right ventricular apical pacing.Methods Seventy patients with chronic right ventricular apical pacing were enrolled in the study.Their paced QRS duration was measured by ECG,and the echocardiographic variables,including aortic root dimension（AO）,left atrial dimension（LAD）,left ventricular end-systolic dimension（LVDs）,left ventricular end-diastolic dimension（LVDd）,interventricular septum thickness （IVST）,left ventricular posterior wall thickness （LVPWT）,and left ventricular eject fraction （LVEF） were measured by echocardiography.The relationships between pQRS duration and the indicated echocardiographic variables were examined.Results The pQRS duration was positively correlated to LVDd （r=0.334,P0.01）,LVDs（r=0.385,P0.01）,LAD（r=0.595,P0.01）,IVST（r=0.289,P0.05）.Besides,there was negative correlation between pQRS duration and LVEF（r=-0.312,P0.05）.If detecting left atrial dilation on the basis of pQRS duration≥180 ms,the sensitivity and specificity were 86.49% and 67.74%,respectively.Conclusion For patients with chronic right ventricular apical pacing,the pQRS duration is correlated with left cardiac structures and LV systolic function.Prolonged pQRS duration （≥180 ms） indicates left atrial dilation.

关 键 词：起搏QRS波时限 左房扩大 左心功能 

分 类 号：R54[医药卫生—心血管疾病]