心力衰竭加重并左室射血分数降低患者的QRS时限与预后  

The prognostic value of QRS duration in heart failure patients with reduced ejection fraction

作　　者：邓春荣[1] 范洪伟[1] 

机构地区：[1]河南煤化集团鹤壁煤业公司总医院ICU,河南省鹤壁市458000

出　　处：《中国心血管病研究》2013年第5期341-344,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的观察住院期间QRs时限对心力衰竭并左室射血分数降低预后的影响。方法回顾性分析心力衰竭并左室射血分数降低（≤40％）或正常的住院患者住院期间的QRs波群时限。结果3002例患者纳入研究，其中正常QRS波群时限1745例（〈120ms），QRS波群延长（≥120ms）1257例。平均随访10个月，基础QRS波群时限正常患者全因死亡率为18．8％，基础QRS波群延长患者为28．3％（nR。1．62，95％CIL38～1．88）。基础QRS波群正常患者心血管死亡和心力衰竭住院率为31．5％和35．8％，延长者则为39．0％和43．6％（朋=1．40、1．42；95％CIL25-1．60、1．18-1．72）。QRS波群时限延长与增加全因死亡率危险性相关（HR=1．25：95％C11．03～1．52），并增加心血管死亡或心力衰竭住院率（HR=1．21、1．28，95％CIL10～1．40、1．12～1．38）。基础Qas波群延长患者最后住院心电图QRS波群正常者仅为4．0％。结论延长的QRS波群在LVEF降低患者中十分多见，是出院后高患病率和高死亡率的独立预测因素。Objective To observe the influence of QRS duration on the prognosis of heart failure patients with reduced left ventricular ejection fraction. Methods A retrospective analysis of inhospital patients with heart failure and reduced （≤40%） or normal left ventricular ejection fraction was done to analyze the QRS wave dura- tion. Results The 3002 patients included in the study included 1745 cases with normal QRS wave duration（〈120 ms） and 1257 eases with prolonged QRS wave（ ≥ 120 ms）. The mean follow-up time was 10 months, patients with normal QRS duration showed a all-cause mortality of 18.8% and those with prolonged QRS wave had a mortality of 28.3% （HR= 1.62, 95%C1 1.38-1.88）. Cardiovascular death or heart failure hospitalization of patients with normal and prolonged QRS wave groups were 31.5%, 35.8% vs 39.0%, 43.6% （HR=1.40, 1.42; 95%CI 1.25-1.60, 1.18- 1.72） respectively. QRS duration prolongation correlated with increased all-cause mortality （HR =1.25; 95% CI 1.03-1.52） and cardiovascular death or heart failure hospitalization （HR=1.21, 1.28, 95%CI 1.10-1.40, 1.12- 1.38 ）. At the last hospitalization time the normal QRS wave was 4% in wide QRS group. Conclusion QRS pro- longation in patients with reduced LVEF is an independent predictor of morbility and mortality.

关 键 词：心力衰竭 左室射血分数 死亡率 患病率 QRS波群 预测 

分 类 号：R541.6[医药卫生—心血管疾病]