心电图QRS波时限缩短对CRT术后反应性的预测价值.docVIP

心电图QRS波时限缩短对CRT术后反应性的预测价值 汤宝鹏 晁慧娟 作者单位：830054 乌鲁木齐市新疆医科大学第一附属医院心脏中心 通讯作者：汤宝鹏 E-mail:tang  HYPERLINK mailto:baopeng@ baopeng@ 【摘要】 目的 研究心脏再同步化治疗（CRT）术后QRS时限缩短值是否对CRT疗效有预测价值。方法 检索1998年6月至2010年10月发表的有关CRT术后QRS时限缩短值对CRT有效性预测性研究，对纳入研究中有关试验设计、研究对象特征、研究结果等内容独立进行摘录，采用Cochrane协作网RevMan5.0软件进行分析。结果 共纳入6项临床研究，共涉及研究人数471人，按CRT术后随访6个月后有无反应性分为对CRT有反应组及无反应组， CRT术后QRS时限缩短在有反应组及无反应组中差异有统计学意义。结论 术后QRS时限缩短值是CRT疗效的一个独立预测因素。 【关键词】 心脏再同步化治疗； 反应性； QRS时限 Value of QRS shortening in predicting response to cardiac resynchronization therapy among patients with end-stage heart failure TANG Bao-peng CHAO Hui-juan, Department of heart center，First Affiliated Hospital of Xinjiang Medical University Urumqi 830054,China Corresponding author：TANG Bao-peng，Email：tangbaopeng@ 【Abstract】Objective To study the predictive value of QRS shortening (ΔQRSd) following cardiac resynchronization therapy (CRT) for response to CRT in patients with end-stage heart failure. Methods The clinical studies of the value of QRS shortening in predicting response to cardiac resynchronization therapy in patients with end-stage heart failure were searched in Medline, Pubmed, Embase from Jun 1998 to Oct 2010, and Cochrane Library (Issue 3, 2010). The methodological quality of these papers was evaluated and the meta-analysis was performed by RevMan5.0 software．Results Six studies including five English papers and one Chinese papers were enrolled and 471 patients met the selection criteria. Meta-analysis results showed that QRS shortening following CRT differed significantly between responders and non-responders, there was a statistical difference in ΔQRS. Conclusion QRS shortening was a predictor of long-term clinical improvement after CRT in patients with severe heart failure. Key words: Cardiac resynchronization therapy; response; QRS duration; 心脏再同步化治疗（CRT）顽固性心力衰竭（简称心衰）经循证医学证实可提高心衰患者生活质量、减少再住院率并可降低患者死亡率[1]。然而，按照目前的入选标准选择病例，仍然有大约30％-40%患者对CRT治疗无反应[2]。但目前临床上仍没有可靠的指标能够预测CRT治疗的反应性。近年部分研究[3-5]显示，提示术后QR