慢性心力衰竭病人QRS综合波幅值及形态的变化  

Changes of Amplitude and Modality of QRS Complex in Patients with Chronic Heart Failure.

作　　者：侯应龙[1] 臧益民[2] 张宁仔[3] 杜日映[3] 朱妙章[2] 

机构地区：[1]海口心血管病研究所,海口市人民医院心内科,海南海口570208 [2]第四军医大学生理教研室,陕西西安710032 [3]第四军医大学唐都医院心内科,陕西西安710038

出　　处：《中国心脏起搏与心电生理杂志》2001年第3期196-198,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：探讨慢性心力衰竭 (CHF)病人QRS综合波幅值及形态的变化与意义。使用常规、高频及动态心电图分别采集 6 0例不同病因CHF病人QRS综合波幅度、QRS切迹与扭挫、室性心律失常等体表心电信息。结果 :QRS幅度的缺血性心脏病 (IHD)与扩张型心肌病 (DCM)较对照组 (1.76± 0 .2 7,1.5 7± 0 .14vs 2 .2 3± 0 .32mV ,P均 <0 .0 5 )降低。IHD、高血压性心脏病 (HHD)与DCM的QRS切迹数的较对照组 (5 .43± 0 .2 5 ,4.36± 0 .19,7.2 3± 0 .46vs 0 .6 4± 0 .11mV)增多 ;各组室性异位搏动显著增加。上述改变随CHF加重愈趋明显。结论 :由QRS综合波幅值及形态变化所反映的心脏电活动异常 。To investigate changes and significance of both amplitude and modality of QRS complex in patients with chronic heart failure(CHF),the amplitude and modality of QRS complex in patients with ischemic heart disease(IHD, n=22 ),hypertensive heart disease(HHD, n=20 )and dilated cardiomyopathy(DCM, n=18 )were measured by means of 12 lead ECG,24 hour ECG(Holter)and high frequency ECG.Results:Compared with control( n=20 ,2.23±0.32 mV),QRS amplitude of patients with IHD(1.76±0.27mV, P<0.05 )and DCM(1.57±0.14 mV, P<0.05 )were reduced.Notching of QRS in patients with IHD(5.43±0.25 mV, P<0.05 ),HHD(4.36±0.19 mV, P<0.05 )and DCM(7.23±0.46 mV, P<0.05 )were increased while that of subjects in control was 0.64±0.11 mV.Ventricular arrhythmia in patients with different heart diseases were also increased.The above changes were more remarkable when CHF was getting more severe.Conclusion:Abnormallites of cardiac electrophysiology indicated by changes of both amplitude and modality of QRS complex may be an electrophysioloical basis of arrhythmias for patients with CHF.

关 键 词：心力衰竭 QRS综合波 高频心电图 

分 类 号：R541.6[医药卫生—心血管疾病] R540.41[医药卫生—内科学]