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目的探讨肺动脉高压患者的右心室内径与QRS间期之间的关系。方法连续入选2003年12月至2008年7月期间在阜外医院肺血管病中心住院治疗并经右心导管证实的肺动脉高压患者。住院当日记录患者静息状态下的标准12导联心电图,选取QRS间期最大的导联。记录患者的基线临床资料、生化标志物、超声心动图检查结果以及右心导管检查结果。结果共纳入224例肺动脉高压患者,根据QRS间期,将患者分为三组,QRS间期<90ms组,QRS间期90~119ms组;QRS间期≥120ms组。三组间的心电图QRS间期、右心室前后径和右心室前后径/左心室前后径均存在显著性差异(P≤0.001);校正性别和心率后差异仍有显著性(P≤0.001)。QRS间期与右心室前后径(r=0.434,P<0.001)和右心室前后径/左心室前后径(r=0.277,P=0.001)显著正相关。三组间的生化标志物、右心导管检测结果均未见明显差异(P>0.05)。结论肺动脉高压患者的右心室内径与12导联心电图的QRS间期相关。
Objective To investigate the relationship between right ventricular internal diameter and QRS interval in patients with pulmonary hypertension. Methods Patients with pulmonary hypertension who were hospitalized in the Center for Pulmonary Vascular Disease of Fu Wai Hospital from December 2003 to July 2008 and were confirmed by right heart catheterization were enrolled. On the day of hospitalization, the standard 12-lead electrocardiogram at rest was recorded and the lead with the largest QRS interval was selected. The patient’s baseline clinical data, biochemical markers, echocardiographic findings and right heart catheterization were recorded. Results A total of 224 patients with pulmonary hypertension were enrolled. According to the QRS interval, the patients were divided into three groups. The QRS interval was less than 90ms, the QRS interval was 90 ~ 119ms, and the QRS interval was more than 120ms. ECG QRS interval between the three groups, right ventricular anteroposterior diameter and right ventricular anterior / posterior diameter / left ventricular anterior and posterior diameter were significantly different (P≤0.001); corrected sex and heart rate difference was still significant (P≤0.001). The QRS interval was positively correlated with anteroposterior RV diameter (r = 0.434, P <0.001) and right ventricular anterior / posterior diameter (RV = 0.277, P = 0.001). Biochemical markers among the three groups, right heart catheterization test showed no significant difference (P> 0.05). Conclusions The right ventricular diameter of patients with pulmonary hypertension is associated with QRS interval of 12-lead electrocardiogram.