心电图QRS时间与慢性心力衰竭患者主要不良心血管事件的关系研究  

Relationship between electrocardiogram QRS duration and major adverse cardiac events in patients with chronic heart failure

作　　者：姜雯 郑和豪[1] 祝飞燕 JIANG Wen;ZHENG Hehao;ZHU Feiyan(Authors'address:Department of Electrocardiogram,Quzhou People's Hospital,Quzhou 324000,China)

机构地区：[1]衢州市人民医院心电图室,324000

出　　处：《心电与循环》2023年第4期345-348,共4页Journal of Electrocardiology and Circulation

摘　　要：目的 分析心电图QRS时间与慢性心力衰竭患者主要不良心血管事件(MACE)的关系。方法 选择2019年3月至2020年4月衢州市人民医院收治的慢性心力衰竭患者102例,根据心电图QRS时间的不同将QRS时间>120 ms的45例患者作为观察组,将QRS时间≤120 ms的57例患者作为对照组,比较两组患者一般资料、MACE发生情况。应用Cox回归分析QRS时间与MACE的关系。结果 观察组患者年龄、病程、左心室质量指数[(72.10±8.55)岁、(9.46±2.49)年、(149.58±13.90)g/m2]大于对照组[(67.35±7.74)岁、(8.14±2.20)年、(135.61±11.80)g/m2],左心室射血分数为(38.49±3.62)%,低于对照组的(43.29±4.11)%,差异均有统计学意义(均P<0.05)。观察组患者致命性心律失常、左心衰竭急性加重、心源性死亡、MACE发生率(24.44%、20.00%、11.11%、55.56%)高于对照组(8.77%、5.26%、1.75%、15.79%),差异均有统计学意义(均P<0.05)。Cox回归分析显示,QRS时间是致命性心律失常、左心衰竭急性加重、MACE的独立危险因素(均P<0.05)。结论 心电图QRS时间延长与慢性心力衰竭患者MACE的发生关系密切,可用作为预后不良指标。Objective To investigate the relationship between electrocardiogram QRS duration and major adverse cardiac events(MACE)in patients with chronic heart failure(CHF).Methods One hundred and two CHF patients admitted to Quzhou People's Hospital from March 2019 to April 2020 were selected.Forty-five patients had QRS duration>120 ms(observation group)and 57 patients had QRS duration≤120 ms(control group).Clinical data and the incidence of MACE were compared between the two groups.Cox regression was used to analyze the relationship between QRS duration and MACE.Results The age,disease course and left ventricular mass index in the observation group[(72.10±8.55)years old,(9.46±2.49)years,(149.58±13.90)g/m2]were significantly higher than those in the control group[(67.35±7.74)years old,(8.14±2.20)years,(135.61±11.80)g/m2](all P<0.05).Left ventricular ejection fraction was significantly lower in the observation group[(38.49±3.62)%]than in the control group[(43.29±4.11)%](P<0.05).The incidence of fatal arrhythmias,acute aggravation of left heart failure,cardiogenic death and overall MACE in the observation group(24.44%,20.00%,11.11%,55.56%)were significantly higher than those in the control group(8.77%,5.26%,1.75%,15.79%)(all P<0.05).Cox regression results showed that QRS duration was an independent risk factor for fatal arrhythmias,acute exacerbation of left heart failure,and overall MACE(all P<0.05).Conclusion Prolonged QRS duration is closely related to MACE occurrence of CHF patients and can be used as a poor prognostic indicator.

关 键 词：慢性心力衰竭 心电图 主要不良心血管事件 QRS时间 

分 类 号：R541.6[医药卫生—心血管疾病]