CAJ | 학술논문

目的：探讨碎裂QRS波（f_QRS ）评价QRS波时限正常的慢性心力衰竭患者心室同步性的应用价值。方法随机选取90例慢性心力衰竭伴窄QRS波患者，统计所有患者体表心电图及超声心动图检查，根据超声心动图结果分为心室同步组（59例）和心室不同步组（31例），分析两组f_QRS波检出率，并分析f_QRS波对慢性心力衰竭患者心室不同步性的诊断价值。结果所有患者中共有32例出现f_QRS波，检出率为35.56％；心室不同步组检出f_QRS波23例，检出率为74.20％，心室同步组检出f_QRS波9例，检出率为15.25％，差异有统计学意义（ P＜0.05）。经ROC分析显示，f_QRS波对心室不同步有一定的诊断价值（Auc＝0.80，P＜0.05）。经Pearson相关性分析显示，f_QRS波出现部位与心室不同步部位存在显著的相关性（ r＝0.81，P＜0.05）。结论 f_QRS出现部位与心室不同步部位密切相关，可以根据体表心电图中f_QRS波出现部位对患者心室不同步的部位进行初步判断，有利于对患者病情的进一步评估。
목적：탐토쇄렬QRS파（f_QRS ）평개QRS파시한정상적만성심력쇠갈환자심실동보성적응용개치。방법수궤선취90례만성심력쇠갈반착QRS파환자，통계소유환자체표심전도급초성심동도검사，근거초성심동도결과분위심실동보조（59례）화심실불동보조（31례），분석량조f_QRS파검출솔，병분석f_QRS파대만성심력쇠갈환자심실불동보성적진단개치。결과소유환자중공유32례출현f_QRS파，검출솔위35.56％；심실불동보조검출f_QRS파23례，검출솔위74.20％，심실동보조검출f_QRS파9례，검출솔위15.25％，차이유통계학의의（ P＜0.05）。경ROC분석현시，f_QRS파대심실불동보유일정적진단개치（Auc＝0.80，P＜0.05）。경Pearson상관성분석현시，f_QRS파출현부위여심실불동보부위존재현저적상관성（ r＝0.81，P＜0.05）。결론 f_QRS출현부위여심실불동보부위밀절상관，가이근거체표심전도중f_QRS파출현부위대환자심실불동보적부위진행초보판단，유리우대환자병정적진일보평고。
Objective To investigate the application value of ventricle synchronism in patients with chronic heart failure while QRS duration is evaluated as normal by fragmented QRS complex (f_QRS ).Methods 90 cases of patients with chronic heart failure compli-cated by narrow QRS were chosen randomly ,all of the examination of surface ECG and echocardiography were analyzed ,the patients were divided into ventricle synchronization group (59 cases) and out_syn group (31 cases) according to the result of ultrasonic cardio-gram.f_QRS wave and diagnostic value of out_syn between f_QRS wave and ventricle of patients with chronic cardiac failure were ana-lyzed.Results Among the 90 patients ,32 cases with f_QRS wave ,the incidence rate was 35.56% ;Among the 31 dyssynchronic cas-es ,23 cases were with f -QRS ,the incidence rate was 74.20% .Ventricular synchronous group consisted of 59 patients ,and f_QRS wave were only 9 cases ,the incidence rate was 15.25% ,there were statistically significant differences ( P<0.05). ROC analysis showed ,f_QRS waves had some diagnostic value on ventricular dyssynchrony (Auc=0.80 , P<0.05).In addition ,the correlation analysis by Pearson showed that f_QRS wave position and ventricular dyssynchrony parts were significantly correlated ( r=0.81 , P<0.05).Conclusions The sites f_QRS appeared was closely related to the sites of ventricular dyssynchrony.It could be used as a pri-mary diagnosis for ventricular dyssynchrony in patients with chronic heart failure ,and it would be helpful to do further evaluation of the condition.