医学研究杂志
醫學研究雜誌
의학연구잡지
Journal of Medical Research
2015年
10期
140-143
,共4页
严亚红%冯朋朋%刘凤%江涛%张田
嚴亞紅%馮朋朋%劉鳳%江濤%張田
엄아홍%풍붕붕%류봉%강도%장전
肺动脉反流%法洛四联症%QRS间期%碎裂QRS波群
肺動脈反流%法洛四聯癥%QRS間期%碎裂QRS波群
폐동맥반류%법락사련증%QRS간기%쇄렬QRS파군
Pulmonary regurgitation%Tetralogy of Fallot%QRS duration%fQRS
目的 探讨通过心电图评估伴有肺动脉反流( PR)的法洛四联症( TOF)患者的右心功能的临床价值. 方法 选取于笔者医院进行TOF矫治手术后合并PR的TOF患者61例作为研究对象,行标准12导联心电图与心脏磁共振( CMR)检查,测定QRS时限、碎裂QRS波群(fQRS),右心室收缩末期容积指数(RVESVi),右心室舒张末期容积指数(RVEDVi),右心室射血分数( RVEF). 对上述数据采用Pearson分析,并进行单因素Logistic回归分析各因素对右心室扩张、功能障碍的影响. 结果 研究对象中有28例患者(45.9%)出现fQRS,45例患者(73.7%) QRS间期时限>120ms,45例患者(73.7%)出现完全性右束支传导阻滞,19例(31.1%)患者RVEF<45%,被诊断为右心功能不全. 30例患者(49.1%) RVESVi>150ml,被诊断为右心室扩张.QRS间期时限与RVEF呈显著负相关( r=-0.60, P=0.000);QRS间期时限分别与RVESVi、RVEDVi呈显著正相关( r=0.63, P=0.000;r=0.55,P=0.000). 出现fQRS患者的QRS间期(156.83 ±25.45ms)显著高于未出现者(131.5 ±26.00ms),差异有统计学意义(P=0.000). 单因素Logistic回归分析显示QRS间期>120ms分别与右心室扩张、右心室功能障碍相关(HR=6.69, P=0.000;HR=10.62,P=0.000). 结论 初步认为可以借助QRS间期辅助判断伴有PR的TOF患者右心室功能障碍,但仍需更多的研究和循证依据.
目的 探討通過心電圖評估伴有肺動脈反流( PR)的法洛四聯癥( TOF)患者的右心功能的臨床價值. 方法 選取于筆者醫院進行TOF矯治手術後閤併PR的TOF患者61例作為研究對象,行標準12導聯心電圖與心髒磁共振( CMR)檢查,測定QRS時限、碎裂QRS波群(fQRS),右心室收縮末期容積指數(RVESVi),右心室舒張末期容積指數(RVEDVi),右心室射血分數( RVEF). 對上述數據採用Pearson分析,併進行單因素Logistic迴歸分析各因素對右心室擴張、功能障礙的影響. 結果 研究對象中有28例患者(45.9%)齣現fQRS,45例患者(73.7%) QRS間期時限>120ms,45例患者(73.7%)齣現完全性右束支傳導阻滯,19例(31.1%)患者RVEF<45%,被診斷為右心功能不全. 30例患者(49.1%) RVESVi>150ml,被診斷為右心室擴張.QRS間期時限與RVEF呈顯著負相關( r=-0.60, P=0.000);QRS間期時限分彆與RVESVi、RVEDVi呈顯著正相關( r=0.63, P=0.000;r=0.55,P=0.000). 齣現fQRS患者的QRS間期(156.83 ±25.45ms)顯著高于未齣現者(131.5 ±26.00ms),差異有統計學意義(P=0.000). 單因素Logistic迴歸分析顯示QRS間期>120ms分彆與右心室擴張、右心室功能障礙相關(HR=6.69, P=0.000;HR=10.62,P=0.000). 結論 初步認為可以藉助QRS間期輔助判斷伴有PR的TOF患者右心室功能障礙,但仍需更多的研究和循證依據.
목적 탐토통과심전도평고반유폐동맥반류( PR)적법락사련증( TOF)환자적우심공능적림상개치. 방법 선취우필자의원진행TOF교치수술후합병PR적TOF환자61례작위연구대상,행표준12도련심전도여심장자공진( CMR)검사,측정QRS시한、쇄렬QRS파군(fQRS),우심실수축말기용적지수(RVESVi),우심실서장말기용적지수(RVEDVi),우심실사혈분수( RVEF). 대상술수거채용Pearson분석,병진행단인소Logistic회귀분석각인소대우심실확장、공능장애적영향. 결과 연구대상중유28례환자(45.9%)출현fQRS,45례환자(73.7%) QRS간기시한>120ms,45례환자(73.7%)출현완전성우속지전도조체,19례(31.1%)환자RVEF<45%,피진단위우심공능불전. 30례환자(49.1%) RVESVi>150ml,피진단위우심실확장.QRS간기시한여RVEF정현저부상관( r=-0.60, P=0.000);QRS간기시한분별여RVESVi、RVEDVi정현저정상관( r=0.63, P=0.000;r=0.55,P=0.000). 출현fQRS환자적QRS간기(156.83 ±25.45ms)현저고우미출현자(131.5 ±26.00ms),차이유통계학의의(P=0.000). 단인소Logistic회귀분석현시QRS간기>120ms분별여우심실확장、우심실공능장애상관(HR=6.69, P=0.000;HR=10.62,P=0.000). 결론 초보인위가이차조QRS간기보조판단반유PR적TOF환자우심실공능장애,단잉수경다적연구화순증의거.
Objective To investigate the value of the electrocardiogram as a predictor of right ventricular function in TOF patients with PR.Methods Sixty-one consecutive patients diagnosed with PR after repair of TOF who met the inclusion criteria (n=122) in our hospital were recruited.The tests included electrocardiography and CMR .QRS duration, fQRS, RVESVi, RVEDVi and RVEF were analyzed.The correlation between QRS duration , fQRS and volume parameters and right ventricular function were analyzed .Independent predictor of right ventricular dilation and dysfunction in logistic regression models were analyzed .Results Twenty -eight patients (45.9%) had fQRS, 45 patients (73.7%) was found QRS duration >120ms and complete right bundle branch block , 19 patients (31.1%)was found RVEF<45%, and 30 patients(49.1%)was found RVESVi>150ml.The Pearson correlation demonstrated a signifi-cant negative correlation between QRS duration and RVEF (r=-0.60, P=0.000) and a significant positive correlation between QRS duration and RVESVi (r=0.63,P=0.000) and RVEDVi (r=0.55,P=0.000).Compared with the QRS duration in patients without fQRS(131.5 ±26.00 ms), patients with fQRS had a significantly higher level of QRS duration (156.83 ±25.45 ms).In logistic regres-sion models, QRS duration>120 ms was found to be the independent predictor of right ventricular dilation and dysfunction (HR=6.69, P=0.000;HR=10.62,P=0.000).Conclusion QRS duration constitutes an independent predictor of the presence of right ventricular dilation and dysfunction in TOF Patients with PR .But more studies are needed to provide more evidences .
