心肌梗死后早期检测出碎裂QRS波的价值研究
发布时间：2018-07-13 12:18
【摘要】：目的心血管疾病是我国乃至世界范围内目前致死率和致残率最高的疾病之一,心肌梗死作为心血管疾病急重症的一种,严重的威胁着人类的健康。早期诊断和合理干预对于提高患者的生存率至关重要。碎裂QRS波是一种新的心电图学指标,现阶段认为检测出碎裂QRS波,可能预示着心梗患者的预后不不佳。但由于临床研究的特殊性,无法系统的梳理f QRS波与急性心梗的关系。本实验通过建立大鼠心肌梗死模型,探讨心肌梗死后早期检测出f QRS的价值。方法健康雄性SD大鼠100只,体重200~300 g,在剔除过术前已经存在的f QRS波的大鼠,随机分为假手术组(S组)、模型组(M组)。采用冠状动脉左前降支结扎的方法构建大鼠心梗模型,假手术组只穿线不结扎。根据术后6小时心电图检测结果,将S组和M组大鼠细分为4个亚组:假手术未检出f QRS波(S0组),假手术检出QRS波(Sf组);模型组未检出f QRS波(M0组),模型组检出QRS波(Mf组)。分别检测每组大鼠心肌标志物指标肌酸激酶同工酶CK-MB、乳酸脱氢酶LDH,炎症指标C-反应蛋白(CRP),病理学指标。并观察术后2月大鼠存活情况,检测术后2月存活大鼠心电图检出f QRS波情况,心肌血管紧张素II受体1(AT1R)表达情况。结果术前心电图筛查时,未手术健康大鼠有2只检测到了fQRS波的存在。术后6小时心电图情况,假手术组有11.54%比例出现f QRS波。相比假手术组,更容易在心梗模型组术后6小时心电图中检出f QRS波,检出比为43.33%。模型组大鼠各项心肌标志物指标均高于比假手术组,病理学检查也提示模型组大鼠出现了大面积的梗死。亚组之间互相对比,检出f QRS波并未使心肌标志物水平增高、病理学结果也无特别差距。模型组大鼠术后炎症指标要明显高于假手术组,而检出Mf组相比未检出M0组,炎症指标上升的更多。心梗组大鼠术后2月的存活率明显低于假手术组大鼠,而Mf组大鼠的存活率要明显低于M0组。术后2个月心电图显示,f QRS波检出明显增多。S0组检出率为上升至36.84%,M0组检出率上升至81.25%,而Mf组大鼠f QRS波始终存在。术后2个月对存活的大鼠心肌切片免疫组化染色,心梗组大鼠术后AT1R的表达明显增多,其中相比M0组Mf组表达了更多的AT1R结论大鼠心梗后早期检查f QRS波并不反应心梗的严重程度,但f QRS波的检出极大的影响着心梗大鼠的存活率
[Abstract]:Objective Cardiovascular disease is one of the diseases with the highest mortality and disability rate in China and the world at present. Myocardial infarction (MI) is a serious threat to human health as one of the acute and severe cardiovascular diseases. Early diagnosis and reasonable intervention are essential to improve survival rate. Fragmentation QRS wave is a new electrocardiographic index. At present, it is considered that the detection of broken QRS wave may predict the poor prognosis of patients with myocardial infarction. However, due to the particularity of clinical research, the relationship between f QRS wave and acute myocardial infarction can not be systematically combed. The purpose of this study was to investigate the value of early detection of f QRS in rats with myocardial infarction. Methods 100 healthy male Sprague-Dawley rats, weighing 200 ~ 300g, were randomly divided into sham operation group (S group) and model group (M group). Rat myocardial infarction model was established by left anterior descending coronary artery ligation. According to the results of electrocardiogram examination at 6 hours after operation, the rats in group S and group M were subdivided into four subgroups: sham operation did not detect fQRS wave (S0 group), sham operation detected QRS wave (SF group), model group did not detect fQRS wave (M0 group), model group detected QRS wave (MF group). Myocardial markers CK-MBs, LDHs, C-reactive protein (CRP) and pathological indexes were measured in each group. The survival of rats was observed 2 months after operation, and the expression of angiotensin II receptor 1 (AT1R) in myocardium was detected by electrocardiogram (ECG). Results during electrocardiogram screening before operation, fQRS waves were detected in 2 unoperated healthy rats. 6 hours after operation, there were 11.54% f QRS waves in sham operation group. Compared with sham operation group, f QRS was more easily detected in ECG of myocardial infarction model group 6 hours after operation, and the detection ratio was 43.33. The indexes of myocardial markers in the model group were higher than those in the sham operation group, and the pathological examination also showed that there was a large area of infarction in the model group. Compared with other subgroups, the f QRS wave did not increase the level of myocardial markers, and there was no special difference in pathological results. The inflammatory indexes in the model group were significantly higher than those in the sham operation group, and the inflammatory indexes in the MF group were higher than those in the non-M0 group. The survival rate of myocardial infarction group was significantly lower than that of sham operation group, while that of MF group was significantly lower than that of M0 group. Two months after operation, electrocardiogram showed that the detection rate of fQRS wave in S0 group increased to 36.84%, and that in M0 group increased to 81.25%, while in MF group, the detection rate of fQRS wave was always present. Two months after operation, the expression of AT1R was significantly increased in the myocardial sections of the surviving rats, and the expression of AT1R was significantly increased in the myocardial infarction group. Conclusion the early examination of f QRS wave after myocardial infarction does not reflect the severity of myocardial infarction, but the detection of f QRS wave significantly affects the survival rate of myocardial infarction rats.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22
本文编号：2119347
[Abstract]:Objective Cardiovascular disease is one of the diseases with the highest mortality and disability rate in China and the world at present. Myocardial infarction (MI) is a serious threat to human health as one of the acute and severe cardiovascular diseases. Early diagnosis and reasonable intervention are essential to improve survival rate. Fragmentation QRS wave is a new electrocardiographic index. At present, it is considered that the detection of broken QRS wave may predict the poor prognosis of patients with myocardial infarction. However, due to the particularity of clinical research, the relationship between f QRS wave and acute myocardial infarction can not be systematically combed. The purpose of this study was to investigate the value of early detection of f QRS in rats with myocardial infarction. Methods 100 healthy male Sprague-Dawley rats, weighing 200 ~ 300g, were randomly divided into sham operation group (S group) and model group (M group). Rat myocardial infarction model was established by left anterior descending coronary artery ligation. According to the results of electrocardiogram examination at 6 hours after operation, the rats in group S and group M were subdivided into four subgroups: sham operation did not detect fQRS wave (S0 group), sham operation detected QRS wave (SF group), model group did not detect fQRS wave (M0 group), model group detected QRS wave (MF group). Myocardial markers CK-MBs, LDHs, C-reactive protein (CRP) and pathological indexes were measured in each group. The survival of rats was observed 2 months after operation, and the expression of angiotensin II receptor 1 (AT1R) in myocardium was detected by electrocardiogram (ECG). Results during electrocardiogram screening before operation, fQRS waves were detected in 2 unoperated healthy rats. 6 hours after operation, there were 11.54% f QRS waves in sham operation group. Compared with sham operation group, f QRS was more easily detected in ECG of myocardial infarction model group 6 hours after operation, and the detection ratio was 43.33. The indexes of myocardial markers in the model group were higher than those in the sham operation group, and the pathological examination also showed that there was a large area of infarction in the model group. Compared with other subgroups, the f QRS wave did not increase the level of myocardial markers, and there was no special difference in pathological results. The inflammatory indexes in the model group were significantly higher than those in the sham operation group, and the inflammatory indexes in the MF group were higher than those in the non-M0 group. The survival rate of myocardial infarction group was significantly lower than that of sham operation group, while that of MF group was significantly lower than that of M0 group. Two months after operation, electrocardiogram showed that the detection rate of fQRS wave in S0 group increased to 36.84%, and that in M0 group increased to 81.25%, while in MF group, the detection rate of fQRS wave was always present. Two months after operation, the expression of AT1R was significantly increased in the myocardial sections of the surviving rats, and the expression of AT1R was significantly increased in the myocardial infarction group. Conclusion the early examination of f QRS wave after myocardial infarction does not reflect the severity of myocardial infarction, but the detection of f QRS wave significantly affects the survival rate of myocardial infarction rats.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22
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相关期刊论文 前3条
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3 何涛;陈蒙华;宋凤卿;;105只健康大鼠心电图分析[J];实用心电学杂志;2006年04期
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