时间射血分数和心率射血分数对心力衰竭患者心功能评估的价值及临床意义

・临床论著・ 时间射血分数和心率射血分数对心力衰竭

患者心功能评估的价值及临床意义

丁绍祥王智杰任旭爱卞妮娜王青

【摘要】 目的比较左心室射血分数（LVEF）及其与相应时间段内心电图QRS波时限的比

值（TEF）、心率的比值（HrEF）对心力衰竭患者心功能评估，探讨相应指标临床应用价值和意义。

方法前瞻性选取咸阳市第一人民医院2015年3月至2016年6月以左心心力衰竭为主窦性心律住

院患者784例。治疗前完成心功能评估及心电图和超声心动图检查。LVEF、TEF及HrEF低值切入

点分别定义为0.5、0.625 ms-1和0.667（次/min）-1。根据纽约心脏病学会（NYHA）心功能分级，

按患者LVEF、TEF、HrEF、心电图QRS波时限、心率及年龄进行分类统计，比较不同心功能时的相

应指标及两者变化的相关性。结果心功能Ⅰ～Ⅳ级患者LVEF分别为：（58.29±5.12）%、（54.23±

7.09）%、（45.85±5.97）%、（34.24±7.92）%，组间两两比较差异均有统计学意义（P＜0.01）；TEF依

次为：（0.696±0.097）ms-1、（0.614±0.109）ms-1、（0.477±0.079）ms-1、（0.329±0.118）ms-1，组间

两两比较差异均有统计学意义（P＜0.01）；HrEF依次为：（0.851±0.125）（次/min）-1、（0.730±0.146）

（次/min）-1、（0.554±0.114）（次/min）-1、（0.377±0.129）（次/min）-1，组间两两比较差异均有统

计学意义（P＜0.05）；QRS波时限依次为：（84.29±7.70）ms、（89.28±8.40）ms、（97.10±10.09）

ms、（109.7±20.73）ms，组间均值两两比较差异均有统计学意义（P＜0.05）；心率依次为：（69.39±

7.81）次/min、（75.81±9.98）次/min、（84.29±9.42）次/min、（94.04±12.78）次/min，组间两两比

较差异均有统计学意义（P＜0.01）。LVEF、TEF及HrEF均与患者心力衰竭严重程度相关，r值分

别为0.710、0.720和0.711（P＜0.01）。LVEF＜50%者占比48.72%（382/784），TEF＜0.625者占比

70.28%（551/784），HrEF＜0.667者占比55.48%（435/784）。两两率间多重比较差异均有统计学意义

（P＜0.01）。结论相对于L VEF，TEF和HrEF对心力衰竭患者心功能评估更为合理，TEF优于HrEF。

【关键词】 心力衰竭；心电描记术；心率；射血分数

Comparison of the timed ejection fraction and the heart rate ejection fraction for evaluting heart

function in patients with heart failure Ding Shaoxiang, Wang Zhijie, Ren Xu'ai, Bian Nina, Wang Qing.

Department of Cardiology, the First People's Hospital of Xianyang City, Xianyang 712000, China

Corresponding: Ding Shaoxiang, Email: dingsx001@

【Abstract】 Objective To compare left ventricular ejection fraction (LVEF) and the ratios of

LVEF divided by the time of electrocardiogram QRS complex (TEF) and heart rate (HrEF) for heart

function evaluation and discuss their significances in clinic. Methods From March 2015 to June 2016,

748 sinus rhythm inpatients with left cardiac insufficiency from the First People's Hospital of Xianyang

City were enrolled in this prospective study, cardiac function assessment and electrocardiogram and cardiac

ultrasonography of the patients had been accomplished before treatment. 0.5, 0.625 ms-1 and 0.667

(times/min)-1 as the low evaluation standard were adopted for LVEF, TEF and HrEF. According to different

heart function classification with New York heart association (NYHA), LVEF, TEF, HrEF, time of

electrocardiogram QRS complex, heart rate and age of the patients were calculated and compared,

including the correlation between heart function classification with NYHA and the relative factors.

Results According to the classification of cardiac functionⅠ-Ⅳ of the patients, the means of LVEF were

(58.29±5.12)%, (54.23±7.09)%, (45.85±5.97)%, (34.24±7.92)%, multiple comparisons between groups

existed statistically significant difference (P<0.01). The means of TEF were (0.696±0.097) ms-1,

DOI:10.3877/cma.j.issn.1674-0785.2017.07.007

作者单位：712000 陕西省，咸阳市第一人民医院心内科

通信作者：丁绍祥，Email: dingsx001@