心力衰竭患者心电图QRS波时限特征及与心脏不良事件关系研究  

The relationship between the changes of electrocardiogram QRS duration features and the occurrence of adverse cardiac events in patients with heart failure

作　　者：杨展玲[1] 樊梁军[1] Zhanling Yang;Liangjun Fan(Department of Electrocardiogram Room,Lishui City People's Hospital,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市人民医院心电图室,丽水323000

出　　处：《中国基层医药》2023年第10期1534-1538,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨心力衰竭患者心电图QRS波时限特征及与心脏不良事件的关系。方法回顾性分析丽水市人民医院2021年6月至2022年6月收治的心力衰竭患者298例的临床资料,根据心力衰竭类型分为舒张性心衰组(158例)和收缩性心衰组(140例);根据是否发生心脏不良事件分为发生组(97例)和未发生组(201例)。另选择同期在该院健康体检者120例作为对照组。分析心电图QRS波时限和超声心动图心功能指标。比较心力衰竭组与对照组QRS波时限和心功能指标变化;比较舒张性心衰组和收缩性心衰组QRS波时限和心功能指标变化;比较心脏不良事件发生组与未发生组QRS波时限和心功能指标变化;受试者工作特征曲线(ROC曲线)分析QRS波时限对心脏不良事件预测价值;Pearson相关分析QRS波时限和心功能与心脏不良事件的相关性。结果心力衰竭组QRS波时限[(125.42±14.35)ms]长于对照组[(78.82±6.49)ms],左室收缩末容积(LVESV)[(156.24±21.42)mL]和左室舒张末容积(LVEDV)[(78.28±9.43)mL]均高于对照组的(107.48±19.23)mL和(45.62±5.42)mL,而左室射血分数(LVEF)[(46.98±4.25)%]低于对照组的(67.94±5.46)%,两组差异均有统计学意义(t=34.17、21.66、35.63、41.88,均P<0.001)。收缩性心衰组QRS波时限[(140.21±18.57)ms]长于舒张性心衰组的(112.31±13.42)ms,LVESV[(183.36±27.67)mL]和LVEDV[(95.39±12.13)mL]均高于舒张性心衰组的(132.21±18.98)mL和(63.12±7.84)ml,而LVEF[(38.19±4.61)%]低于舒张性心衰组的(54.77±4.92)%,两组差异均有统计学意义(t=16.29、20.30、29.61、34.18,均P<0.001)。心脏不良事件发生组QRS波时限[(169.37±17.43)ms]长于未发生组的(104.21±12.49)ms,心脏不良事件发生组LVESV[(199.30±23.41)mL]和LVEDV[(105.22±15.64)mL]均高于未发生组的(135.46±15.46)mL和(65.28±6.92)mL,而LVEF[(32.97±5.16)%]低于未发生组的(53.74±4.52)%,两组差异均有统计学意义(t=36.91、28.04、30.57、35.46,均P<0.001)。经ROC曲线分Objective To investigate the relationship between the changes of electrocardiogram QRS duration features and the occurrence of adverse cardiac events in patients with heart failure.Methods The clinical data of 298 patients with heart failure who received treatment in Lishui City People's Hospital from June 2021 to June 2022 were retrospectively analyzed.According to the type of heart failure,they were divided into the diastolic heart failure group(n=158)and the systolic heart failure group(n=140).According to whether having cardiac events,they were divided into a cardiac event group(n=97)and a non-cardiac event group(n=201)group.An additional 120 patients who concurrently received health examinations were included in the control group.QRS wave duration and cardiac function indicators were analyzed.QRS wave duration and cardiac function indicators were compared between heart failure and control groups.Changes in QRS wave duration and cardiac function indicators were compared between diastolic heart failure and systolic heart failure groups.Changes in QRS wave duration and cardiac function indicators were compared between cardiac event and non-cardiac event groups.The value of the receiver operating characteristic curve in predicting adverse cardiac events was analyzed.Pearson correlation analysis was performed to analyze the correlation between QRS wave duration and cardiac function.Results QRS wave duration in the heart failure group was(125.42±14.35)ms,which was significantly longer than(78.82±6.49)ms in the control group(t=34.17,P<0.001).Left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)in the heart failure group were(156.24±21.42)mL and(78.28±9.43)mL,respectively,which were significantly higher than(107.48±19.23)mL and(45.62±5.42)mL,respectively in the control group(t=21.66,35.63,both P<0.01).Left ventricular ejection fraction(LVEF)in the heart failure group was(46.98±4.25)%,which was significantly lower than(67.94±5.46)%in the control group(t=41.88,P<0.001).QRS

关 键 词：心电描记术 图QRS波时限 心力衰竭 舒张性心衰 收缩性心衰 心功能 心脏不良事件 预测价值 相关性 

分 类 号：R541.6[医药卫生—心血管疾病]