QRS间期与射血分数保留性心力衰竭患者长期预后的关系  

Relation between QRS Duration and Long-term Prognosis of Patients with Heart Failure with Preserved Ejection Fraction(HFPEF)

作　　者：易莉莎[1] 武庆平[1] 谢飞[2] 郭超[3] 袁世荧[4] 刘宏[4] 漆红[4] 姚尚龙[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022 [2]华中科技大学同济医学院附属协和医院心内科,武汉430022 [3]华中科技大学同济医学院附属协和医院心外科,武汉430022 [4]华中科技大学同济医学院附属协和医院重症医学科,武汉430022

出　　处：《华中科技大学学报（医学版）》2014年第1期83-85,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.30930089)

摘　　要：目的 探讨QRS间期延长是否影响射血分数保留性心力衰竭（heart failure with preserved ejection fraction,HFPEF）患者的长期预后.方法根据纳入标准,入选264例HFPEF患者,按QRS间期宽度分为正常组（≤120 ms）和延长组（＞120 ms）,分别为174例和90例,随访至2012年12月,比较两组终点事件（全因死亡）的差异,并通过Cox危险模型分析QRS间期延长对终点事件的影响.结果 平均随访1.8年,延长组全因病死率高于正常组（46.7% vs.31.6%）,差异有统计学意义（P＜0.01）;单因素风险模型分析显示,QRS间期延长增加HFPEF患者的全因病死率（危险比：HR 1.67,95%CI：1.32～2.16,P＜0.01）,校正相关因素后,趋势仍未改变（HR 1.12,95%CI 1.05～1.19,P＜0.05）.结论 QRS间期延长是HFPEF患者全因病死率的独立危险因素.Objective To examine the impact of prolonged QRS duration on the long-term prognosis of patients with heart failure with preserved ejection fraction（HFPEF）. Methods A total of 264 HFPEF patients who were enrolled according to the inclusion criteria were divided into normal group（174 cases, QRS duration ≤120 ms）and prolongation group（90 cases, QRS du- rational20 ms）. They were followed up until December 2012. The outcome event（all-cause death）was compared between the two groups. The effect of the prolonged QRS duration on the outcome event was examined by using Cox proportional hazards model. Results The mean follow-up time was 1.8 years. It was found that the all-cause death rate was higher in the prolonga- tion group than in the normal group（46.7% vs. 31.6%）with the difference being statistically significant（P〈0.01）. The univa- riate hazards model also showed that the prolonged QRS duration increased the all-cause death rate of HFPEF patients（HR 1.67,95%CI 1.32--2.16,P〈0.01）. After adjusting for the relevant factors,the trend was not changed（HR 1.12,95% CI 1.05--1.19, P〈 0.05）. Conclusion QRS prolongation is an independent risk factor for long-term mortality of HFPEF pa-

关 键 词：QRS间期 射血分数保留性心力衰竭 预后 

分 类 号：R541.6[医药卫生—心血管疾病]