慢性心力衰竭患者aVR QRS电压影响因素分析  

Influence Factors of a VR QRS Amplitude in Patients with Chronic Heart Failure

作　　者：杨广[1] 明蕾[1] 侯悦丽[1] 程文娟[1] 李向东[1] 

机构地区：[1]山东大学附属千佛山医院老年心内科,山东省济南市250014

出　　处：《中国全科医学》2015年第8期957-959,共3页Chinese General Practice

摘　　要：目的探讨慢性心力衰竭患者a VR QRS电压（ΣQRSa VR）的影响因素,以及利用ΣQRSa VR判断慢性心力衰竭患者预后的意义。方法选取2013年2—10月在山东大学附属千佛山医院住院治疗的符合纽约心功能分级（NYHA）Ⅱ~Ⅳ级的慢性心功能不全患者46例,对患者行心电图描记,采用Stegel法测量QRS波振幅,计算ΣQRSa VR和肢体6导联QRS振幅总和（Σ6Lblds）;行心脏彩色多普勒超声心动图,检测左心室舒张末期内径（LVEDD）及左心室射血分数（LVEF）;并抽取患者血液检测血清脑钠肽（BNP）和肌酐（Cr）水平。采用多元线性回归分析影响慢性心力衰竭患者ΣQRSa VR的因素。结果 46例患者ΣQRSa VR为（0.7±0.2）mm。相关性分析结果显示,慢性心力衰竭患者ΣQRSa VR与Σ6Lblds、体质量以及LVEDD均有相关性（r=0.760、-0.250、-0.052,P〈0.05）。多元线性回归分析结果显示,Σ6Lblds、体质量以及LVEDD是影响慢性心力衰竭患者ΣQRSa VR的因素（P〈0.05）,线性回归方程为y=-0.012＋0.12×Σ6Lblds-0.007×体质量-0.006×LVEDD。结论Σ6Lblds、体质量以及LVEDD是影响慢性心力衰竭患者ΣQRSa VR的主要因素,动态观察ΣQRSa VR可反映慢性心力衰竭患者体质量变化,预示病情转归,还可作为反映心室重构的临床观察指标。Objective To investigate the influence factors of a VR QRS amplitude（ ΣQRSa VR） in patients with chronic heart failure and its judgment in the prognosis of the patients. Methods 46 patients with chronic heart failure with the grade of NYHA Ⅱ- Ⅳ hospitalized in Mount Qianfo Affiliated Hospital of Shandong University from February to October,2013 were selected as the subjects. This study conducted electrocardiography for the patients, measured QRS amplitude by Stegel method and calculated the sum of a VR（ ΣQRSa VR） and 6 limb leads（ Σ6Lblds）. This study also conducted colorful Doppler ultrasonocardiogram to assess left ventricular end- diastolic diameter（ LVEDD） and left ventricular eject fraction（ LVEF） and drew patients＇ blood to determinate the level of natriuretic peptide（ BNP） and creatinine（ Cr）. Multiple linear regression analysis was used for the influencing factors. Results ΣQRSa VR of the 46 patients was（ 0. 7 ± 0. 2） mm. Correlation analysis indicated that Σ6Lblds,body weight and LVEDD were key influence factors of ΣQRSa VR（ r = 0. 760,- 0. 250,- 0. 052,P 0. 05）. Multiple linear regression showed that Σ6Lblds,body weight and LVEDD were the influencing factors of ΣQRSa VR in chronic heart failure patients（ P 0. 05）,linear regression equation was y =- 0. 012 ＋ 0. 12 × Σ6Lblds- 0. 007 × BW- 0. 006× LVEDD. Conclusion Σ6Lblds,body weight and LVEDD are key influence factors of ΣQRSa VR. Dynastic observation ofΣQRSa VR can not only reflect change of body weight and evaluate patients＇ condition but also be the clinical index of ventricular remodeling in patients with chronic heart failure.

关 键 词：心力衰竭 心电描记术 a VR 

分 类 号：R541.6[医药卫生—心血管疾病]