碎裂QRS波群在心肌梗死心肌瘢痕中的诊断价值  

Diagnosis value of fragmented QRS complexes in myocardial scar after myocardial infarction

作　　者：刘金城[1] 寇兰英[1] 张立英[1] 王庆海[1] 段红梅[1] 张立清[1] 韩文忠[1] 

机构地区：[1]河北医科大学附属沧州中西医结合医院心内科,061001

出　　处：《中国实用医刊》2011年第1期72-73,共2页Chinese Journal of Practical Medicine

摘　　要：目的观察碎裂QRS波（fQRs）在心肌梗死心肌瘢痕中的诊断价值。方法对心肌梗死患者不同治疗方式开通冠状动脉循环，于发病后4、8周应用同步12导联心电图观察fQRS，结合心脏多普勒超声观察左室射血分数（LVEF），对心肌梗死患者心肌瘢痕及心功能进行对比研究。结果本组患者于发病后4、8周fQRS阳性导联数随梗死相关冠状动脉的有效开通而减少，组间fQRS阳性导联数比较差异有统计学意义（P〈0．05）；fQRS＋LVEF对心肌瘢痕的敏感性、特异性和阴性预测值分别为96．5％、92．0％和97．4％。结论fQRS对心肌瘢痕的诊断价值在纽间结果中得到充分肯定，“罪犯”血管开通越早，抗栓治疗越充分，心肌微循环结构和功能损害越轻，则心肌瘢痕形成越局限，fQRS阳性比率越低，以溶栓再通＋经皮冠状动脉介入术（PCI）及急诊PCI组最理想。Objective To observe the diagnosis value of fragmented QRS complexes （fQRS） in myocardial scar after myocardial infarction. Methods Coronary artery circulation was opened to different treatments in patients with myocardial infarction. At the 4th week and the 8th week after being taken bad, by using twelve synchronization cardiogram to observe fQRS, unioning the heart Doppler supersonic to look into LVEF, in order to make comparative study of myocardial infarction and cardiac function in pa- tients with myocardial scar. Results With the effective opening of the infarct - related coronary artery, the fQRS positive leads of the patients was reduced at the 4th week and the 8th week after being taken bad. There was significant difference between the two groups fQRS positive leads compare（ P 〈 0.05 ） ; the sensitivity, specificity and negative predictive value of fQRS ＋ LVEF to myocardial scar was 96. 5% ,92% and 97.4% respectively. Conclusions The diagnosis value of fQRS to myocardial scar have been fully affirmed in the inter - group results. The earlier ＂criminal＂ blood vessel openes, the more adequate antithrombotic treatment is, the lighter cardiac microcirculation structure and functional damage, then the more limited formation of myocardial scar and the lower fQRS - positive ratio, it could be conclu- ded that the thrombolytic recanalization ＋ PCI and emergency PCI group is most ideal.

关 键 词：碎裂QRS波群 心肌梗死 心肌瘢痕 心脏功能 

分 类 号：R542.22[医药卫生—心血管疾病]