心电图额面QRS参数与慢性心衰病情及预后的关联研究  

A study on the correlation of frontal QRS parameters on electrocardiogram with the condition and prognosis of chronic heart failure

作　　者：田冰 季小贵 TIAN Bing;JI Xiao-gui

机构地区：[1]开封市祥符区第一人民医院(开封市第三人民医院)心血管内科,河南开封475100

出　　处：《中国疗养医学》2024年第10期84-88,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的分析心电图额面QRS参数与慢性心力衰竭(CHF)患者病情严重程度及预后水平的关联。方法选取开封市祥符区第一人民医院2022年1月至2023年6月收治的115例CHF患者为研究对象,开展回顾性研究。参考美国纽约心脏病协会(NYHA)心功能分级标准,将其中55例Ⅰ~Ⅱ级患者列为轻症组,其余60例Ⅲ~Ⅳ级患者列为重症组,比较两组患者的心功能参数,心电图额面QRS参数,主要心血管不良事件(MACE)发生情况;通过Spearman相关性系数检验心电图额面QRS参数与CHF患者心功能指标间的关联;通过绘制受试者工作特征曲线(ROC)并观察线下面积(AUC)验证QRS参数对MACE发生风险的预测效能。结果经检测,重症组的左心室射血分数(LVEF)低于轻症组,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、额面QRS-T夹角、QRS波时限、MACE发生率高于轻症组,差异均具有统计学意义(P<0.05)。额面QRS-T夹角与LVEF负相关,与LVEDD、LVESD正相关,QRS波时限与LVEF负相关,与LVEDD、LVESD正相关;额面QRS-T夹角、QRS波时限对CHF的MACE发生风险的预测灵敏度为81.45%、81.23%,特异度为80.22%、77.49%,截断值分别为132.75°、122.81 ms(AUC>0.85)。结论心电图额面QRS-T夹角、QRS波时限越高,CHF患者的心功能越差;监测额面QRS-T夹角、QRS波时限能实现对患者MACE发生风险的有效预测。Objective To analyze the correlation of frontal QRS parameters on electrocardiogram with the severity and prognosis of chronic heart failure(CHF).Methods A retrospective study was conducted on 115 CHF patients admitted to Xiangfu District First People's Hospital from January 2022 to June 2023.According to the New York Heart Association(NYHA)Functional Classification,55 ClassⅠ-Ⅱpatients were included in the mild group,and the remaining 60 ClassⅢ-Ⅳpatients were included in the severe group.The cardiac function parameters,frontal QRS parameters on electrocardiogram,and the incidence of major adverse cardiovascular events(MACEs)were compared between the two groups.Spearman correlation coefficient was used to test the correlation between frontal QRS parameters on electrocardiogram and cardiac function indicators in CHF patients.The predictive effectiveness of QRS parameters on the risk of MACEs was validated by drawing the receiver operating characteristic(ROC)curves and calculating the area under the curve(AUC).Results The left ventricular ejection fraction(LVEF)in the severe group was significantly lower than that in the mild group,and left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),frontal QRS-T angle,QRS complex time limit,and incidence of MACEs were significantly higher than those of the mild group(P<0.05).The frontal QRS-T angle was negatively correlated with LVEF and positively correlated with LVEDD and LVESD.The QRS wave duration was negatively correlated with LVEF and positively correlated with LVEDD and LVESD.The sensitivity of frontal QRS-T angle and QRS time limit on predicting MACEs in CHF patients was 81.45%and 81.23%,respectively,with the specificity of 80.22%and 77.49%,and the cut-off value of 132.75°and 122.81 ms(AUC>0.85),respectively.Conclusion Higher frontal QRS-T angle and QRS wave duration on the electrocardiogram predict a worse cardiac function of CHF patients.Monitoring the frontal QRS-T angle and QRS wave duration can effectively predict t

关 键 词：慢性心力衰竭 心电图额面参数 预后情况 相关性分析 预测效能 

分 类 号：R541.6[医药卫生—心血管疾病]