碎裂QRS波诊断陈旧性心肌梗死价值的探讨  

Value of fQRS for the diagnosis of old myocardial infarction

作　　者：马淑英[1] 吕金兰[1] 张媛[1] 刘振波[1] 卜培莉[1] 王乐信[2] 马龙乐[1] 李志平[1] 

机构地区：[1]山东聊城市人民医院,252000 [2]山东大学齐鲁医院

出　　处：《临床心电学杂志》2012年第1期27-29,共3页Journal of Clinical Electrocardiology

基　　金：山东医药卫生发展计划项目项目编号:2009HZ015

摘　　要：目的通过统计陈旧性心肌梗死患者各心电图指标的发生情况,探讨fQRS对陈旧性心肌梗死的诊断价值。方法选择352例陈旧性心肌梗死患者进行心电图检查,根据QRS形态,分为病理性Q波、fQRS、病理性Q波和(或)fQRS,又根据心肌梗死的不同部位进行心电图指标的统计分析。结果 352例陈旧性心肌梗死患者心电图有病理性Q波者117例,有fQRS者184例,有病理性Q波和(或)fQRS者226例。对陈旧性心肌梗死诊断的敏感性中,病理性Q波31.8%,fQRS46.6%,病理性Q波和(或)fQRS58.2%。对陈旧性心肌梗死诊断的特异性中,病理性Q波96.4%,fQRS85.4%,病理性Q波和(或)fQRS84.7%。结论 fQRS诊断陈旧性心肌梗死的敏感性高于病理性Q波,但诊断特异性低于病理性Q波,较病理性Q波有较高的阴性预测值。两者结合有更高的敏感性和阴性预测值。fQRS对陈旧性心肌梗死有明确的诊断价值。Objective Through statistical old myocardial infarction（OMI） patients’ electrocardiogram indexes, to discuss the diagnostic value of fQRS conditions underlying myocardial infarction. Methods According to QRS forms in a cardiogram, 352 OMI cases were divided into pathological Q, fQRS, pathologic Q and fQRS, and analyze the electrocardiogram index based on the different parts of myocardial infarction. Results In 352 OMI cases, pathological Q wave 117 cases, fQRS 184 cases, fQRS and the pathological Q 226 cases. About the sensitivity of OMI diagnosis, pathological Q wave 31.8%, fQRS 46.6% and that pathological Q wave and fQRS 58.2%. About the specificity of OMI diagnosis, pathological Q wave 96.4%, fQRS 85.4%, pathologic Q wave and the fQRS 84.7%. Conclusion In the aspect of the OMI diagnosis, the fQRS has a higher sensitivity than pathological Q wave, but below in the pathologic diagnostic specificity, Meanwhile compared with a pathological Q has higher negative predictive value. Both have higher sensitivity and negative predictive value. fQRS underlying myocardial infarction are clearly on the diagnosis value.

关 键 词：陈旧性心肌梗死 碎裂QRS波 病理性Q波 

分 类 号：R542.22[医药卫生—心血管疾病]