QRS波群时限及QT离散度对慢性心力衰竭患者预后的预测价值

目的 探讨QRS波群时限及QT离散度对慢性心力衰竭患者预后的预测价值.方法 对2007年6月至2009年5月在我院住院的慢性心力衰竭患者98例,进行常规十二导联同步心电图及24小时十二导联同步动态心电图监测,测量并计算其QRS波群时限及QTd,并统计其心律失常发生的情况,追踪其住院期间心脏病事件发生情况.结果 对于慢性心力衰竭患者,（1）A组与B组、C组各组间两两比较的QRS波群时限差别有显著意义（P均〈0.01）;（2）与A组比较,B组的QTd差别没有显著意义（P〉0.05）,C组的QTd差别有显著意义（P〈0.01）;与B组比较,C组的QTd差别有显著意义（P〈0.05）;（3）与A组比较,B组、C组的恶性心律失常及心脏病事件的发生率差别具有显著性意义（P均〈0.01）;与B组比较,C组的恶性心律失常及心脏病事件的发生率增大有显著性意义（P〈0.01,P〈0.05）;（4）与D组比较,E组的ORS波群时限、QTd差别均有显著性意义（P均〈0.01）.结论 慢性心力衰竭患者随心功能级别的增加,QRS波群时限、QTd增加,其恶性心律失常及心脏病事件的发生率增加,QRS波群时限、QTd可以用于慢性心衰患者预后的初步评价.

The relationship of QRS complex duration with QT interval dispersion and arrhythmias on heart failure patients

Objective： To investigat the value of QRS prolongation and QT interval dispersion to prognosis predictor in the patients with chronic heart failure. Methods： Ninty-eight patients with chronic heart failure in Taian Central Hospital from June 2007 to May 2009 were monitored with the common 12-lead synchronously electrocardiogram and the 24h dynamic electrocardiogram to caculate the QRS complex duration and QT interval dispersion, and the statistics of occurrence of ar- rhythmias. Results： In the chronic heart failure patients： （1） compared with group A, the difference in QRS complex duration was notable in group B and group C （P 〈0. 01 respectively）. （2） the difference in QT interval dispersion was not notable between group A and group B（P 〉0. 05） , but the difference of it was notable between group A and group C（P 〈 0. 01 ）. The difference in QT interval dispersion was notable between group B and group C（P 〈0. 05）. （3） Compared with group A, the difference in the proportion of maligant arrhythmia and cardiovascular events was notable in group B and group C （P 〈0. 01 respectively）. Compared with group B, the difference in the proportion was notable in group C （P 〈0.01 or P 〈 0. 05 ）. （4） The difference in QRS complex duration and QT interval dispersion was notable between group D and group E（ P 〈 0. 01 respectively）. Conclusion ： Along with increasing of NYHA, the figure of QRS complex duration and QT interval dispersion increase equally, so is the proportion of maligant arrhythmia and cardiovascular events. The QRS complex duration and QT interval dispersion can be used as a criteria to estimate the prognosis in the patients with chronic heart failure.