高血压伴有心电图碎裂QRS波患者左室结构和功能的变化  

Changes of left ventricular structure and function in patients with hypertension accompanied by electrocardiographic fragmentation of QRS wave

作　　者：张炳山[1] 谈君[2] 李宗斌[3] 洪侃[1] 王滨[1] 万鹤鸣[1] ZHANG Bing-shan;TAN Jun;LI Zong-bin;HONG Kan;WANG Bin;WAN He-ruing(Department of Geriatrics Wuxi People's Hospital,Wuxi 214023,Jiangsu,China;Department of Cardiac Function Wuxi People's Hospital,Wuxi 214023,Jiangsu,China;Department of Cardiology,Wuxi People's Hospital,Wuxi 214023,Jiangsu,China)

机构地区：[1]南京医科大学附属无锡市人民医院老年医学科,江苏无锡214023 [2]南京医科大学附属无锡市人民医院心功能科,江苏无锡214023 [3]南京医科大学附属无锡市人民医院心血管内科,江苏无锡214023

出　　处：《中国心脏起搏与心电生理杂志》2018年第6期538-541,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的研究常规心电图上碎裂QRS波在高血压患者左室结构和功能变化中的意义。方法选取冠状动脉造影结果正常的高血压患者102例,分为fQRS(-)组和fQRS(+)组,进行超声心动图检查,比较两组患者左室结构及功能指标。结果共44例高血压患者检出fQRS,检出率为43.1%。与fQRS(-)组患者相比,fQRS(+)组患者室间隔、左室后壁增厚(P<0.05);左室舒张末内径和收缩末期内径扩大(P<0.01);左室质量和质量指数增加、左房最大容积增大(P<0.01)。左室长轴缩短率下降(P<0.01);E峰降低、A峰升高、E/A比值下降(P<0.05);E峰减速度时间延长、e′降低、E/e′升高(P<0.01)。fQRS(+)组左室肥厚患者比例高(P<0.01)。结论高血压患者常规心电图上出现碎裂QRS波,提示患者左室肥厚,左室收缩和舒张功能受损。Objective To study the significance of fragmented QRS waves on routine electrocardiogram in left ventricular structure and function changes in patients with hypertension. Methods In this study,102 hypertensive patients with normal coronary angiography were selected,divided into fQRS(-)group and fQRS(+)group,and echocardiography was performed to compare the left ventricular structure and function of the two groups. Results A total of 44 patients with hypertension detected fQRS,and the detection rate was 43.1%.Compared with those indexes in the aQRS(-)groupin the fQRS(+)group,the ventricular septum and left posterior wall thickened(P<0.05).Left ventricular end-diastolic and systolic diameter increased(P<0.01).Left ventricular mass,left ventricular mass index and left atrial maximal volume were increased(P<0.01).Left ventricular long axis shortening rate decreased(P<0.01).E velocity decreased,A velocity increased,E/A ratio decreased(P<0.05).E velocity deceleration time extended,e’decreased,E/e’increased(P<0.01).The proportion of patients with left ventricular hypertrophy in the fQRS(+)group was higher than that in the fQRS(-)group(P<0.01). Conclusion In hypertensive patients,fragmented QRS was observed in the routine electrocardiogram,which indicating that the left ventricular hypertrophy,left ventricular systolic and diastolic function are impaired.

关 键 词：心血管病学 高血压 碎裂QRS波 心肌纤维化 心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病] R540.41[医药卫生—内科学]