老年心力衰竭患者QRS时限6分钟步行试验分析

目的探讨老年慢性心力衰竭（心衰，CHF）患者QRS时限（QRSD）与心功能、运动耐量相关性。方法47例老年慢性心衰患者（心衰组），20例健康对照组常规心电图测量QRS时限，在心衰组根据QRSD分为QRSD≤120ms组、QRSD〉120ms组。以左心室射血分数（LVEF）、左室舒张末期内径（LVDED）作为心脏功能指标与6分钟步行试验（6-MWT）进行组间比较。结果心衰组QRSD、LVDED值均明显高于对照组（P〈0．001），LVEF、6-MWT值均明显低于对照组（P〈0．005）。在心衰组QRSD与LVDED呈正相关，与LVEF、6-MWT呈负相关。结论在慢性心衰患者中监测QRS时限和6分钟步行试验，2种方法联合应用尤其适合于基层医院，可指导临床采取相应的社区干预模式，制定最佳治疗方案。

Correlations between QRS Duration and Cardiac Function in Elderly Patients with Chronic Heart Failure

Objective To investigative the correlations between QRS duration （QRSD） and heart function and 6-minute walk test（6-MWT,）in elderly patients with chronic heart failure（CHF）. Methods QRSD of 47cases of elderly patients with CHF and 20 heahhy control were measured by conventional ECG. The patients with CHF were divided into two groups according to QRSD： QRSD 〉 120 ms group（ n =26） ,QRSD≤ 120 ms group（ n =21 ）. The left ventricular ejection fraction（LVEF） and left ventricular end diastolic diameter（LVDED） ,as indicators of heart function,were compared with 6-MWT among groups. Results QRSD as well as the LVDED value in heart failure group was obviously higher than that in control group（93.75 ±5.36 vs 80.14 ±9.32, t = 7. 539, P 〈 0.001 ;57.94 ± 6.37 vs 48.61 ± 5.72,t = 5. 648, P 〈 0.001 ）. LVEF as well as the 6-MWT value was obviously lower than the control group （41.22 ± 5.11 vs 60.47 ± 7.16, t = 14. 112, P 〈 0.001 ; 340.42 ± 85.54 vs 405.50 ± 60.68, t = 3. 073 ,P 〈 0. 005 ）. In heart failure group,there was positive correlation between QRSD and NYHA and negative correlation between 6-MWT and LVEF. Conclusions QRSD is associated with the heart function and 6-MWT of CHF. QRSD with 6-MWT is very useful in the diagnosis and protocol making for CHF in primary hospital.