目的 探讨心电图QRS时限与心力衰竭患者左室结构、功能的关系.方法 回顾性分析2012年6月~10月吉林大学中日联谊医院心内科收治的473例心力衰竭患者(心衰组)及同期就诊的100例健康体检者(非心衰组),根据心电图QRS时限将心衰组分为QRS时限<100 ms组(n=271),QRS时限100 ms~119 ms组(n=108),QRS时限≥120 ms组(n=94)三个亚组.比较心衰组、非心衰组之间QRS时限、左房内径(LA)、左室舒张末期内径(LVEDd)的差异,比较心衰组三亚组之间左室射血分数(LVEF)、左室短轴缩短分数(LVFS)、LA、LVEDd的差异,分析QRS时限与心脏超声指标间的相关性.结果 心衰组较非心衰组QRS时限明显延长(101.45 msvs.94.95 ms,P=0.000)、LA明显增大(39.73 mmvs.31.07 mm,P=0.000)、LVEDd明显增大(51.88 mmvs.43.54 mm,P=0.000).心衰组三亚组之间LVEF、LVFS、LA、LVEDd有显著差异(P<0.05),且QRS时限与LVEF呈负相关,与LA、LVEDd呈正相关(P<0.05).结论 心电图QRS时限可作为心力衰竭病情严重程度及衰竭心脏心室重构的评价指标.
Objective To discuss the relationship between electrocardiographic QRS duration (QRSd) and left ventricular structure and function in patients with heart failure (HF).Methods HF patients (n=473) were chosen as HF group and patients without HF (n=100) were chosen as non-HF group from Jun. 2012 to Oct. 2012, and given retrospective analysis. The HF group was divided again into subgroup 1 (QRSd<100 ms,n=271), subgroup 2 (QRSd from 100 ms to 119 ms,n=108) and subgroup 3 (QRSd≥120 ms,n=94) according to QRSd. The difference in QRSd, left atrial diameter (LAD) and left ventricular end-diastolic inner diameter (dimension) (LVEDd) were compared between HF group and non-HF group. The difference in left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), LAD and LVEDd were compared among 3 subgroups. The correlation between QRSd and indexes of echocardiogram was analyzed.Results QRSd was significantly longer (101.45 ms vs. 94.95 ms,P=0.000), LAD was significantly larger (39.73 mmvs. 31.07,P=0.000) and LVEDd was significantly larger (51.88 mmvs. 43.54 mm,P=0.000) in HF group than those in non-HF group. LVEF, LVFS, LA and LVEDd had significant difference among 3 subgroups (P<0.05). QRSd was negatively correlated to LVEF and positively correlated to LAD and LVEDd (P<0.05).Conclusion The electrocardiographic QRSd is an index for reviewing the severity of HF and ventricular remodeling.