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目的探讨心电图在心脏再同步化治疗(CRT)应答中的预测价值。方法选取接受CRT(D)的患者作为研究对象,术后随访至少6个月,根据临床效果分为应答组与无应答组。分析术前术后患者QRS波时限,术前ST段下移值、QTc间期、有无病理性Q波及QRS波切迹对CRT应答是否有预测价值。结果共入选51例患者,6例失访,剩余45例纳入研究,24例CRT有应答,比例为53.3%,死亡8例。应答组术前心电图存在QRS波切迹明显低于无应答组(5/24 vs 16/21例,P=0.03);应答组术后心电图QRS波时限显著短于无应答组[(137.1±27.9)ms vs(166.3±28.5)ms,P<0.05],且对CRT预后有预测价值(OR=0.964,95%CI 0.942~0.998,P=0.004),分界值为125 ms。结论心电图对CRT的应答有一定的预测作用。
Objective To investigate the predictive value of electrocardiogram in cardiac resynchronization therapy (CRT) response. Methods Patients undergoing CRT (D) were selected as study subjects and were followed up for at least 6 months. According to the clinical effect, they were divided into response group and non-response group. Preoperative and postoperative patients with QRS wave duration, preoperative ST segment down, QTc interval, with or without pathological Q wave and QRS wave notch on the CRT response whether there is a predictive value. Results A total of 51 patients were enrolled. Six patients were lost to follow-up. The remaining 45 patients were included in the study. Twenty-four patients responded to CRT, with a proportion of 53.3% and 8 deaths. QRS wave notch in preoperative ECG was significantly lower in response group than that in nonresponse group (5/24 vs 16/21, P = 0.03); QRS wave duration of postoperative electrocardiogram was significantly shorter in response group than in nonresponse group [(137.1 ± 27.9) ms vs (166.3 ± 28.5) ms, P <0.05]. The prognostic value of CRT was predictive (OR = 0.964,95% CI 0.942-0.998, P = 0.004) Conclusion Electrocardiogram has a certain predictive value for CRT response.