老年冠心病患者心电图QTc间期、QRS时限值与疾病严重程度及临床转归的关系研究

Study on relationship between electrocardiogram QTc interval and QRS duration and disease severity and clinical outcomes in elderly patients with coronary heart disease

中文关键词: 老年  冠心病  心电图  QTc间期  QRS时限值  疾病严重程度  临床转归

英文关键词: elderly  coronary heart disease  electrocardiogram  QTc interval  QRS duration  disease severity  clinical outcome

中文摘要:

      目的 分析老年冠心病(CHD)患者心电图QTc间期、QRS时限值与疾病严重程度及临床转归的关系.方法 回顾性分析2020年1月1日—2024年10月31日绵阳市第一人民医院收治的老年CHD患者98例,依据Gensini疾病严重程度分为轻度组(n=30,Gensini评分0～24分)、中度组(n=40,Gensini评分25～49分)、重度组(n=28,Gensini评分≥50分);依据不良心血管事件(MACE)发生情况分MACE组(n=29)和非MACE组(n=69).以多因素Logistic回归分析QTc间期、QRS时限值与老年CHD疾病严重程度及临床转归的关系,以受试者工作特征(ROC)曲线下面积(AUC)检验QTc间期、QRS时限值评估老年CHD疾病严重程度、病情转归的价值.结果 中、重度组QTc间期、QRS时限值较轻度组更长(P＜0.05);多因素分析显示,QTc间期、QRS时限值上升为老年CHD病情加重的独立风险因素(P＜0.05);ROC曲线显示,QTc间期、QRS时限值联合评估老年CHD疾病严重程度的AUC为0.888(P＜0.05);QTc间期、QRS时限值MACE组较非MACE组更长(P＜0.05);多因素分析显示,QTc间期、QRS时限值上升为老年CHD临床不良转归的独立风险因素(P＜0.05);ROC曲线显示,QTc间期、QRS时限值联合评估老年CHD临床转归的AUC为0.880(P＜0.05).结论 心电图QTc间期、QRS时限值变化与老年CHD患者疾病严重程度及临床转归密切相关,可依据这些指标评估老年CHD病情进展及转归情况,以为临床治疗提供指导.

英文摘要:

      Objective To analyze the relationship of electrocardiogram QTc interval and QRS duration and disease se-verity and clinical outcomes in elderly patients with coronary heart disease(CHD).Methods A retrospective analysis was conducted on 98 elderly CHD patients admitted to First People's Hospital of Mianyang City between January 1,2020,and Oc-tober 31,2024.According to the Gensini disease severity score,they were divided into mild(n=30,Gensini score 0-24),moderate(n=40,Gensini score 25-49),and severe groups(n=28,Gensini score ≥50).In addition,according to the oc-currence of adverse cardiovascular events(MACE),they were divided into MACE group(n=29)and non-MACE group(n=69).Multivariate Logistic regression was used to analyze the relationship between QTc interval and QRS duration and dis-ease severity and clinical outcomes of elderly CHD.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the value of QTc interval and QRS duration in assessing CHD severity and outcomes of patients.Results The QTc interval and QRS duration in the moderate and severe groups were longer than those in the mild group(P＜0.05).Multivariate analysis suggested that QTc interval and increased QRS duration were independent risk factors for the ag-gravation of CHD(P＜0.05).ROC curve revealed that the AUC of QTc interval combined with QRS duration in evaluating the severity of CHD was 0.888(P＜0.05).The QTc interval and QRS duration in the MACE group were longer than those in the non-MACE group(P＜0.05).Multivariate analysis indicated that prolonged QTc interval and increased QRS duration were independent risk factors for poor clinical outcomes of elderly CHD patients(P＜0.05).ROC curve showed that the AUC of combination of QTc interval and QRS duration in assessing clinical outcomes of the elderly CHD patients was 0.880(P＜0.05).Conclusion The changes of electrocardiogram QTc interval and QRS duration are closely related to disease severity and clinical outcomes of elderly CHD patients.These indicators can be used to evaluate the disease progression and outcomes of elderly CHD patients,so as to provide guidance for clinical treatment.