碎裂QRS波对扩张型心肌病患者预后的预测价值  

Predictive value of fragmented QRS complex for prognosis of patients with dilated cardiomyopathy

作　　者：林晓明[1] 杨希立[1] 刘鹤龄[1] 

机构地区：[1]广东省佛山市第一人民医院心内科,528000

出　　处：《实用医学杂志》2015年第2期225-227,共3页The Journal of Practical Medicine

基　　金：广东省卫生厅科研基金项目(编号:A2009653)

摘　　要：目的：探讨碎裂QRS波（fQRS）对扩张型心肌病（DCM）患者预后的预测价值。方法：对166例DCM患者和100例健康对照者进行12导联心电图检查，根据患者是否存在fQRS分为fQRs组和无fQRs组，比较fORs在DCM组和健康对照组的发生率，比较DCM患者中fORS组和无fQRS组心血管事件的发生率，并进行多变量Cox回归分析。结果：DCM组fQRs发生率显著高于对照组（P〈0．01）；DCM患者中fQRs组心源性猝死、非猝死性心性死亡、恶性心律失常、左室射血分数（LVEF）降低和严重房室传导阻滞发生率显著高于无fQRs组（P〈0．01—0．001）；多变量Cox回归分析显示：fQRs对DcM的影响有显著统计学意义（P〈0．01）。结论：fQRs可成为心电图诊断DcM的新指标，是DCM患者心血管事件的预测因子。Objective To assess the predictive value of fragmented QRS （fQRS） complex for prognosis of patients with dilated cardiomyopathy （DCM）. Methods One hundred and sixty-six patients with DCM and one hundred healthy controls were enrolled in this study. According to the existence of fQRS complex, the DCM patients were divided into the fQRS group and the non-fragmented QRS （nonfQRS） goup. The incidence rats of fQRS between the DCM patients and the control group were compared. The incidence rates of the cardiovascular events between the fQRS group and the nonfQRS group were compared, and the multivariate COX regression was analyzed. Results The incidence rate of fQRS in the DCM group was significantly higher than that of the control group （P 〈 0.0!）. The incidence rates of cardiac death and the ventricular arrhythmia, and the decrease of left ventricular ejection fraction （LVEF） and the serious A-V block in patients of the fQRS group were significantly higher than those of patients in the nonfQRS group. The multivariate COX regression analysis showed that fQRS was the independent risk factor for cardiac sudden death. Conclusion fQRS could serve as a new indicator for diagnosis of DCM, it is a predictive factor for cardiovascular events in DCM patients.

关 键 词：心肌病 扩张型 碎裂QRS波 心血管事件 

分 类 号：R542.2[医药卫生—心血管疾病]