碎裂QRS波及左心室肥大对原发性高血压患者室性心律失常的预测价值  

Predictive value of fragmented QRS complex and left ventricular hypertrophy for ventricular arrhythmias in patients with primary hypertension

作　　者：许悦悦 吕聪敏[1] 张萌 李小妞 赵心珠 XU Yueyue;LV Congmin;ZHANG Meng;LI Xiaoniu;ZHAO Xinzhu(Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450003,China)

机构地区：[1]郑州大学第二附属医院心内科,河南郑州450003

出　　处：《实用心电学杂志》2024年第1期19-23,共5页Journal of Practical Electrocardiology

基　　金：河南省医学教育研究课题(YJSJY201971)。

摘　　要：目的探讨碎裂QRS波及左心室肥大对原发性高血压(primary hypertension,PH)患者室性心律失常(ventricular arrhythmia,VA)的预测价值。方法选取261例PH住院患者,均行常规心电图、动态心电图、动态血压、超声心动图等检查。根据动态心电图检查结果,将所有入选患者分为VA组(129例)和非VA组(132例)。比较和分析各组患者的一般资料、生化指标等检验检查结果。将经单因素分析后有意义的数据纳入多因素Logistic回归,分析碎裂QRS波、左心室肥大与VA的关系,并绘制ROC曲线。结果VA组低密度脂蛋白胆固醇水平、碎裂QRS波阳性率、左心室后壁厚度、左心室舒张末期内径均高于非VA组(P<0.05)。Logistic回归分析结果显示,碎裂QRS波与左心室肥大是PH患者发生VA的独立危险因素。ROC曲线分析表明,碎裂QRS波与左心室肥大联合预测VA发生的风险优于单独预测效果。结论碎裂QRS波与左心室肥大是PH患者发生VA的独立危险因素。两者联合对VA发生风险的预测效果优于单独预测效果。Objective To investigate the predictive value of fragmented QRS complex and left ventricular hypertrophy for ventricular arrhythmia(VA)in patients with primary hypertension(PH).Methods A total of 261 inpatients with PH were selected,and they all underwent routine electrocardiography,ambulatory electrocardiography(AECG),ambulatory blood pressure monitoring,echocardiography,and other examinations.Based on the results of AECG,the enrolled patients were divided into VA group(129 cases)and non-VA group(132 cases).Laboratory and examination results of general information and biochemical indicators were compared and analyzed between the two groups.Significant variables identified through univariate analysis were included in multivariate Logistic regression analysis to explore the relationship between fragmented QRS complex,left ventricular hypertrophy,and VA.Results In the VA group,the level of low-density lipoprotein cholesterol,positive rate of fragmented QRS complex,left ventricular posterior wall thickness,and left ventricular end-diastolic diameter were all higher than those in the non-VA group(P<0.05).Logistic regression analysis revealed that fragmented QRS complex and left ventricular hypertrophy were independent risk factors for VA in patients with PH.ROC curve analysis indicated that the combination of fragmented QRS complex and left ventricular hypertrophy was superior to either of the individual indicator in predicting the risk of VA.Conclusion Fragmented QRS complex and left ventricular hypertrophy are independent risk factors for the occurrence of VA in patients with PH.The combination of the two is superior to either of the individual indicator in predicting the risk of VA.

关 键 词：碎裂QRS波 左心室肥大 原发性高血压 室性心律失常 

分 类 号：R544.11[医药卫生—心血管疾病] R541.7[医药卫生—内科学]