97例运动后QRS间期异常延长的康复期老年慢性心力衰竭患者临床资料分析
Analysis of Clinical Data of 97 Elderly Patients with Chronic Heart Failure with Abnormal QRS Interval after Exercise

为探讨伴有运动后QRS间期延长的慢性心力衰竭患者的临床特征。方法：对97例运动后QRS ≥ 9 ms的康复期老年慢性心力衰竭患者行六分钟步行试验(6MWT)、心电图、身高、体重、血压、血脂和血糖水平检测，并与104例运动后QRS < 9 ms的康复期老年慢性心力衰竭患者比较。结果：伴有运动后QRS间期延长的康复期慢性心力衰竭患者其体重水平、体重指数水平、胆固醇水平和甘油三酯水平较对照组高，心功能 ≥ 3级、肥胖、高血压和糖尿病的比率高。logistic回归显示，舒张压、高血压、肥胖、糖尿病是运动后QRS间期异常延长的独立危险因素。提示伴有运动后QRS间期异常延长的康复期老年慢性心力衰竭患者，其心血管疾病基础疾病还没有完全恢复，运动后心率不升。结论：伴有运动后QRS异常延长的康复期老年慢性心力衰竭患者，其心血管疾病高危因素聚集，患者运动后心率明显减慢。对于康复期老年慢性心力衰竭患者，应当积极检测其运动后QRS水平，对伴有运动后QRS异常延长的患者，应当加强卫生宣教，积极控制其基础疾病，提倡健康生活方式，慎用运动复方。
Objective: To investigate the clinical characteristics of chronic heart failure patients with prolonged QRS interval after exercise. Methods: The six-minute walking test (6MWT) , electrocardiogram (ECG) , height, weight, blood pressure, blood lipids and blood glucose levels were measured in 97 patients with chronic heart failure (CHF) at convalescent stage and QRS ≥9 ms after exercise, and compared with 104 cases of QRS < 9 ms after exercise in the convalescent elderly patients with chronic heart failure. Results: compared with the control group, the patients with QRS interval prolongation after exercise had higher body weight, higher body mass index, higher cholesterol and higher triglyceride levels, the rates of heart function ≥ 3, obesity, hypertension and diabetes were high. Logistic regression analysis showed that diastolic blood pressure, hypertension, obesity and diabetes mellitus were independent risk factors for abnormal prolongation of QRS interval after exercise. It is suggested that the elderly patients with chronic heart failure at convalescent stage with abnormal prolongation of QRS interval after exercise have not fully recovered from the underlying diseases of cardiovascular diseases, and their heart rate does not rise after exercise. Conclusion: the high-risk factors of cardiovascular disease in the elderly patients with chronic heart failure at convalescent stage with abnormal prolongation of QRS after exercise accumulate, and the heart rate of the patients after exercise obviously slows down. The QRS level after exercise should be positively detected in the convalescent patients with chronic heart failure, and health education should be strengthened in the patients with abnormal prolongation of QRS after exercise to actively control their underlying diseases, promote healthy lifestyle, careful use of sports compound.