QRS、QT、QTc及LVEF预测心源性猝死的价值分析  

Value Analysis of QRS,QT,QTc and LVEF in Predicting Sudden Cardiac Death

作　　者：张敏[1] 李阳春 雷蓉[1] 杨静[1] 王欢[1] 王玉泉[1] 王玉兵[1] ZHANG Min;LI Yang-chun;LEI Rong;YANG Jing;WANG Huan;WANG Yu-quan;WANG Yu-bing(Department of Cardiology,Affiliated Hospital of North Sichuan Medical University,Sichuan,637000,China)

机构地区：[1]川北医学院附属医院心内科,四川南充637000

出　　处：《现代生物医学进展》2022年第12期2352-2355,共4页Progress in Modern Biomedicine

基　　金：四川省医学科研课题计划项目(Q160064);南充市科技项目(19SXHZ0207)。

摘　　要：目的:探讨QRS时限值(QRS)、QT间期延长(QT)、QTc间期(QTc)及左室射血分数(LVEF)预测心源性猝死的价值分析。方法:选择2018年1月至2019年12月川北医学院附属医院心血管内科治疗的356例心源性猝死患者进行研究,设为病例组,并选择同期体检的健康人200例作为对照组,分析QRS、QT、QTc及LVEF水平变化情况及其预测价值。结果:病例组QRS、QTc水平显著高于对照组,QT、LVEF水平显著低于对照组,差异显著(P<0.05);轻度QRS、QTc显著低于中度、重度患者,QT、LVEF水平显著高于中度、重度患者;中度患者QRS、QTc显著低于重度患者,QT、LVEF水平显著高于重度患者,差异显著(P<0.05);ROC结果显示,QRS预测心源性猝死的AUC为0.989,灵敏度△为84.59%,特异度为87.68%,截断值为115.59ms;QT预测心源性猝死的AUC为0.944,灵敏度85.12%,特异度为88.45%,截断值为21.69ms;QTc预测心源性猝死的AUC为0.984,灵敏度为86.05%,特异度为88.61%,截断值为416.39ms,LVEF预测心源性猝死的AUC为0.997,灵敏度87.15%,特异度为89.05%,截断值为45.63%,(P<0.05)。结论:QRS、QT、QTc及LVEF在心源性猝死患者中检查,可显著提高心源性猝死临床诊断效能。Objective:To study Value analysis of QRS duration limit(QRS),QT interval prolongation(QT),QTc interval(QTc)and Left ventricular ejection fraction(LVEF)in predicting sudden cardiac death.Methods:356 patients with sudden cardiac death treated in the Department of Cardiology,Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2019 were selected as the case group,and 200 healthy subjects who underwent physical examination during the same period were selected as the control group.Changes in QRS,QT,QTc and LVEF levels and their predictive value were analyzed.Results:The levels of QRS and QTc in case group were significantly higher than those in control group,while the levels of QT and LVEF were significantly lower than those in control group(P<0.05).Mild QRS and QTc were significantly lower than moderate and severe patients,while QT and LVEF levels were significantly higher than moderate and severe patients.QRS and QTc in moderate patients were significantly lower than those in severe patients,while QT and LVEF levels were significantly higher than those in severe patients,the difference was significant(P<0.05).ROC results showed that THE AUC of QRS for predicting sudden cardiac death was 0.989,the sensitivity was 84.59%,the specificity was 87.68%,and the cut-off value was 115.59 ms.The AUC of QT for predicting sudden cardiac death was 0.944,the sensitivity was 85.12%,the specificity was 88.45%and the cut-off value was 21.69 ms.The AUC of QTc for predicting sudden cardiac death was 0.984,the sensitivity was 86.05%,the specificity was 88.61%,and the cutoff value was 416.39ms,while the AUC of LVEF for predicting sudden cardiac death was 0.997,the sensitivity was 87.15%,the specificity was 89.05%,and the cutoff value was 45.63%(P<0.05).Conclusion:QRS,QT,QTc and LVEF can significantly improve the clinical diagnostic efficiency of sudden cardiac death.

关 键 词：QRS时限值 QT间期延长 QTC间期 左室射血分数 心源性猝死 预测价值 

分 类 号：R541.78[医药卫生—心血管疾病] R540.41[医药卫生—内科学]