CAJ | 학술논문

目的探讨心力衰竭患者出现心电图QRS波群时限延长的临床意义.方法回顾性分析心力衰竭患者心电图QRS波群时限及其超声心动图参数,并按照心电图QRS波群时限将其分为QRS≥120 ms组和QRS＜ 120 ms组,比较两组患者的心功能分级、超声心动图参数、恶性心律失常发生率、1年内病死率,以探讨QRS波群时限与美国纽约心脏病学会(NYHA)心功能分级、左心室舒张末期内径(LVEDd)、左室射血分数(LVEF)、左室短轴缩短分数(LVFS)、恶性心律失常发生率、病死率的关系.结果 QRS≥120 ms组和QRS＜120 ms组患者的心功能差异无统计学意义(t=0.00、0.10、0.11,P＞0.05).心电图QRS波群时限≥120 ms组患者的LVEDd值明显高于心电图QRS波群时限＜120 ms组患者(t=3.31,P＜0.05),而LVFS值和LVEF值明显低于心电图QRS波群时限＜120 ms组患者(t=17.05、3.54,均P＜0.05).但是,两组患者的LAD差异无统计学意义(t=0.09,P＞0.05).40例心电图QRS波群时限≥120 ms组患者在住院期间出现恶性心律失常8例,心源性死亡6例,合并肺部感染死亡2例.心电图QRS波群时限＜120 ms组在住院期间出现恶性心律失常4例,心源性死亡3例,感染性休克1例,心电图QRS波群时限≥120 ms组患者的恶性心律失常发生率和1年内病死率均明显高于心电图QRS波群时限＜120 ms组患者(x2=4.01,P＜0.05).在心电图QRS波群时限≥120 ms组6例心源性死亡患者中LVEDd均大于70 mm,LVEF均小于30％.结论 QRS波群时限延长(≥120 ms)与心力衰竭患者的心功能级别、性别、年龄无关,但是与恶性心律失常发生率和1年内病死率有关,可作为心力衰竭患者病情严重程度及预后不良的评估方法.
목적 탐토심력쇠갈환자출현심전도QRS파군시한연장적림상의의.방법 회고성분석심력쇠갈환자심전도QRS파군시한급기초성심동도삼수,병안조심전도QRS파군시한장기분위QRS≥120 ms조화QRS＜ 120 ms조,비교량조환자적심공능분급、초성심동도삼수、악성심률실상발생솔、1년내병사솔,이탐토QRS파군시한여미국뉴약심장병학회(NYHA)심공능분급、좌심실서장말기내경(LVEDd)、좌실사혈분수(LVEF)、좌실단축축단분수(LVFS)、악성심률실상발생솔、병사솔적관계.결과 QRS≥120 ms조화QRS＜120 ms조환자적심공능차이무통계학의의(t=0.00、0.10、0.11,P＞0.05).심전도QRS파군시한≥120 ms조환자적LVEDd치명현고우심전도QRS파군시한＜120 ms조환자(t=3.31,P＜0.05),이LVFS치화LVEF치명현저우심전도QRS파군시한＜120 ms조환자(t=17.05、3.54,균P＜0.05).단시,량조환자적LAD차이무통계학의의(t=0.09,P＞0.05).40례심전도QRS파군시한≥120 ms조환자재주원기간출현악성심률실상8례,심원성사망6례,합병폐부감염사망2례.심전도QRS파군시한＜120 ms조재주원기간출현악성심률실상4례,심원성사망3례,감염성휴극1례,심전도QRS파군시한≥120 ms조환자적악성심률실상발생솔화1년내병사솔균명현고우심전도QRS파군시한＜120 ms조환자(x2=4.01,P＜0.05).재심전도QRS파군시한≥120 ms조6례심원성사망환자중LVEDd균대우70 mm,LVEF균소우30％.결론 QRS파군시한연장(≥120 ms)여심력쇠갈환자적심공능급별、성별、년령무관,단시여악성심률실상발생솔화1년내병사솔유관,가작위심력쇠갈환자병정엄중정도급예후불량적평고방법.
Objective To investigate the clinical significance of ECG QRS wave extension of the time limit for heart failure patients.Methods A retrospective analysis of heart failure patients electrocardiogram QRS complex duration and ultrasound heartbeat graph parameters were conducted,and according to the ECG QRS complex duration the patients were divided into QRS ≥ 120ms group and Q RS ＜ 120ms group,The cardiac functional grading,ultrasound heartbeat graph parameters,incidence rate of malignant arrhythmia,mortality within 1 year were compared between the two groups,in order to explore the possibility of QRS complex duration and the United States of America New York Heart Association(NYHA) classification of cardiac function,left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),malignant arrhythmia incidence,mortality.Results No significant difference was found in the cardiac function between QRS ≥ 120ms group and QRS ＜120ms group(t =0.00,0.10,0.11,all P ＞ 0.05).LVEDd of ECG QRS complex duration ≥ 120ms group was significantly higher than that of ECG QRS complex duration ＜ 120ms group (t =3.31,P ＜ 0.05).In addition,LVFS value and LVEF value of ECG QRS complex duration≥ 120ms group were significantly lower than those of ECG QRS complex duration ＜ 120ms group (t =17.05,3.54,all P ＜0.05).However,LAD between the two groups had no significant difference(t =0.09,P ＞ 0.05).40 cases in ECG QRS complex duration ≥ 120ms group,8 cases had malignant arrhythmia in the hospital,6 cases of cardiac death,2 patients died of pulmonary infection.In ECG QRS complex duration ＜ 120ms group,4 cases had malignant arrhythmia during hospitalization,3 cases of cardiac death,1 cases died of septic shock.The incidence rate of malignant arrhythmia and mortality within 1 year of ECG QRS complex duration ≥120ms group were significantly higher than those of ECG QRS complex duration ＜ 120ms group (x2 =4.01,P ＜0.05).In the ECG QRS complex duration ≥ 120ms group,LVEDd of 6 cardiac death patients was higher than 70mm,LVEF was less than 30％.Conclusion Wave duration ≥ 120ms has nothing to do with the cardiac function grade,gender,age,heart failure,but relate with the incidence rate of malignant arrhythmia and mortality within 1 year,which can be used to evaluate disease severity and prognosis.