碎裂QRS波与急性心肌梗死患者冠脉病变及心脏事件的相关性

发布时间：2018-04-27 18:23

  本文选题：碎裂QRS波 + 心肌梗死　； 参考：《中国老年学杂志》2017年24期

【摘要】：目的探讨急性心肌梗死(AMI)患者心电图碎裂QRS(fQRS)波与冠脉病变程度及心脏事件的相关性。方法根据AMI患者心电图有无fQRS波,分为fQRS组和nfQRS组。记录病史资料、检验指标、心电图、冠脉造影及随访结果,计算SYNTAX评分,评估冠脉病变情况,记录心脏事件的发生情况。结果与nfQRS组相比,fQRS组肌钙蛋白(c Tn)I、肌酸激酶同工酶(CK-MB)、肌酐(Cr)、尿酸(UA)、脑钠肽(BNP)、D-二聚体(D-D)水平显著升高,左室舒张末期内径(LVEDD)显著加大,左室射血分数(LVEF)显著降低(均P0.05)。fQRS组多支病变、SYNTAX评分显著高于nfQRS组(均P0.01),单支病变显著低于nfQRS组(均P0.01)。随访期间,fQRS组室性心动过速/室颤、心源性休克、心源性死亡、严重心力衰竭、再发心肌梗死、再次血运重建发生率均显著高于nfQRS组(P0.05)。与fQRS导联数3组患者相比较,fQRS导联数≥3组患者室性心动过速/室颤、心源性休克、心源性死亡、严重心力衰竭的发生率均显著升高(P0.05)。结论 fQRS可作为预测冠脉病变程度及心脏不良事件的指标,提高AMI高危患者的预警作用。
[Abstract]:Objective to investigate the correlation between electrocardiogram (ECG) fragmentation of QRSs f QRS and the severity of coronary artery disease and cardiac events in patients with acute myocardial infarction (AMI). Methods the patients with AMI were divided into fQRS group and nfQRS group according to whether there were fQRS waves in ECG. Record the history, test index, electrocardiogram, coronary angiography and follow-up results, calculate the SYNTAX score, assess the coronary lesions, record the occurrence of cardiac events. Results compared with nfQRS group, the levels of troponin I, creatine kinase isoenzyme (CK-MBN), creatinine (Cr), uric acid (UAA), brain natriuretic peptide (BNP), D-dimer (D-D) and left ventricular end-diastolic diameter (LVEDDD) were significantly increased in FQRS group. The left ventricular ejection fraction (LVEF) was significantly lower in P0.05).fQRS group than in nfQRS group (P 0.01), and that in single vessel lesion group was significantly lower than that in nfQRS group (P 0.01). During the follow-up period, the incidence of ventricular tachycardia / ventricular fibrillation, cardiogenic shock, cardiogenic death, severe heart failure, recurrent myocardial infarction and re-revascularization in fQRS group was significantly higher than that in nfQRS group (P 0.05). The incidence of ventricular tachycardia / ventricular fibrillation, cardiogenic shock, cardiogenic death and severe heart failure in patients with fQRS leads 鈮，

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