扩张型心肌病 QRS 时限和左室结构改变及其相关性研究

摘要

Objective To observe dilated cardiomyopathy patients ’ QRS duration and left ventricular diastolic end diastolic diameter (LVEDD), left ventricular systolic end-diastolic diameter (LVESD), left ventricular posterior wall thick-ness (LVPW) and left ventricular ejection fraction (LVEF), and to explore the correlation of each index.Methods From January 2010 to December 2013, 50 cases of dilated cardiomyopathy were enrolled as the case group, and according to QRS duration, they were divided to≤110 ms subgroup (15 cases) and >110 ms subgroup (35 cases);65 cases of healthy sub-jects were enrolled as the healthy control group, QRS duration, LVEDD, LVESD, LVPW, LVEF were measured and com-pared.Correlation among QRS duration and LVEDD, LVESD, LVPW, LVEF were analyzed.Results Compared with health control group, case group patients’ QRS duration, LVEDD, LVESD were all increased ( P <0.01) , LVEF were decreased ( P <0.01), LVPW did not show differences ( P >0.05).In≥110 ms subgroup, LVEDD, LVESD were increased than<110 ms subgroup ( P <0.05), LVPW, LVEF did not show statistical significance differences ( P >0.05).Dilated car-diomyopathy patients’ QRS duration and LVEDD, LVESD, LVEF were highly correlated ( r =0.834, P <0.01;r =0.754, P <0.01;r =0.440, P <0.05), and did not have significant correlation with LVPW ( r =-0.273, P >0.05).Conclu-sion Dilated cardiomyopathy patients’ QRS duration and LVEDD, LVESD, LVEF are positively correlated, joint application can help physician to guide clinical treatment.%目的：观察扩张型心肌病患者 QRS 时限及左室舒张末期内径（ LVEDD ）、左室收缩末期内径（LVESD）、左室后壁厚度（LVPW）及左室射血分数（LVEF）的影响，并探讨各指标的相关性。方法2010年1月—2013年12月收治的扩张型心肌病患者50例设为病例组，又根据QRS时限分为≤110 ms亚组15例和＞110 ms亚组35例；同期健康体检者65例设为健康对照组，均测量QRS时限、LVEDD、LVESD、LVPW、LVEF并进行比较，分析病例组QRS时限与LVEDD、LVESD、LVPW、LVEF的相关性。结果与健康对照组比较，病例组患者QRS时限、LVEDD、LVESD均增宽、增大（ P ＜0沣．01）、LVEF减低（ P ＜0．01），LVPW 无差异（ P ＞0．05）。≥110 ms亚组的LVEDD、LVESD较≤110 ms亚组增大（ P均＜0．05），LVPW、LVEF比较差异无统计学意义（ P ＞0．05）。扩张型心肌病患者QRS时限与LVEDD、LVESD、LVEF高度相关（ r ＝0．834， P ＜0．01；r ＝0．754， P ＜0．01；r ＝0．440， P ＜0．05），与LVPW无明显相关性（ r ＝－0．273， P ＞0．05）。结论扩张型心肌病患者QRS时限与LVEDD、LVESD、LVEF呈正相关，联合应用有利于医师把握病情进展并指导临床治疗。