CAJ | 학술논문

目的：探讨QRS间期联合心率变异对慢性心力衰竭(CHF)患者病情评估及预后预测的价值。方法选取2011年4月至2014年5月收治入院的CHF患者210例,收集体表心电图、Hoter分析及超声心动图资料，统计其住院期间室性心律失常事件情况，回顾性分析QRS间期、心率变异(HRV)与NYHA心功能分级、左心室功能、室性心律失常及心脏事件的关系。结果(1)不同QRS间期组的CHF患者NYHA心功能分级程度比较差异均具有统计学意义(P<0.05)，随着QRS时间延长，NYHA心功能级别增加。(2)不同QRS间期各组间左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)、室性心律失常及心脏事件比较差异具有统计学意义(P<0.05)。(3) HRV时域指标随NYHA心功能分级增加而呈递减性下降，NYHA级别越高，HRV降低越明显，差异具有统计学意义(P<0.05)。结论 CHF患者的HRV、QRS波群间期与左心功能损害、心脏事件的发生密切相关，QRS间期联合HRV检测有助于CHF的病情评估、预后预测及指导治疗。
목적：탐토QRS간기연합심솔변이대만성심력쇠갈(CHF)환자병정평고급예후예측적개치。방법선취2011년4월지2014년5월수치입원적CHF환자210례,수집체표심전도、Hoter분석급초성심동도자료，통계기주원기간실성심률실상사건정황，회고성분석QRS간기、심솔변이(HRV)여NYHA심공능분급、좌심실공능、실성심률실상급심장사건적관계。결과(1)불동QRS간기조적CHF환자NYHA심공능분급정도비교차이균구유통계학의의(P<0.05)，수착QRS시간연장，NYHA심공능급별증가。(2)불동QRS간기각조간좌심실서장말기내경(LVEDD)、좌실사혈분수(LVEF)、실성심률실상급심장사건비교차이구유통계학의의(P<0.05)。(3) HRV시역지표수NYHA심공능분급증가이정체감성하강，NYHA급별월고，HRV강저월명현，차이구유통계학의의(P<0.05)。결론 CHF환자적HRV、QRS파군간기여좌심공능손해、심장사건적발생밀절상관，QRS간기연합HRV검측유조우CHF적병정평고、예후예측급지도치료。
Objective To explore the value of heart rate variability and QRS duration for assessing the condi-tion and prognosis of patients with chronic heart failure (CHF). Methods A total of 210 patients with CHF admitted into our hospital from April 2011 to May 2014 were enrolled in the study, with electrocardiogram, Hoter analysis and ultrasonic cardiogram information collected. The ventricular arrhythmia events in hospital were recorded, and the rela-tionships between QRS duration, heart rate variability (HRV) and NYHA classification, left ventricular function, ven-tricular arrhythmia, as well as cardiac events were analyzed. Results (1) NYHA classification showed statistically significant differences between different QRS duration groups (P<0.05), and NYHA level increased with the prolonga-tion of QRS duration. (2) Left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), ventricular arrhythmia and cardiac events all showed statistically significant difference between different QRS dura-tion groups (P<0.05). (3) HRV time domain index decreased significantly with the increase of NYHA classification (P<0.05), and the higher the NYHA classification, the more remarkable the decrease of HRV. Conclusion The HRV, QRS duration is closely related to left ventricular dysfunction and cardiac event rate in the patients with CHF. The alli-ance between QRS duration and HRV examination is beneficial to CHF condition assessment, prediction of prognosis and guiding therapy.