碎裂QRS波与冠状动脉病变的关系研究  

Correlation between Fragmented QRS Wave and Coronary Lesions

作　　者：林晓明[1] 杨希立[1] 刘鹤龄[1] 赖玉琼[1] 郑玲[1] 

机构地区：[1]广东省佛山市第一人民医院心内科,528000

出　　处：《中国全科医学》2013年第11期1238-1239,1243,共3页Chinese General Practice

基　　金：广东省卫生厅科研基金项目(A2009653)

摘　　要：目的探讨碎裂QRS(fQRS)波与冠状动脉病变的关系。方法选择2010—2011年在我院心内科住院的冠心病(CAD)患者216例,根据是否存在fQRS波分为fQRS波组(n=124)和无fQRS波组(n=92),分析不同冠状动脉病变范围、狭窄程度及罪犯血管对fQRS波发生的影响及经皮冠状动脉介入治疗(PCI)前后fQRS波的变化。结果不同病变血管患者fQRS波检出率间差异无统计学意义(P>0.05)。不同病变范围和不同狭窄程度患者fQRS波检出率间差异有统计学意义(P<0.05);其中单支病变与双支病变、三支病变患者fQRS波检出率间差异均程度为有统计学意义(P<0.05),完全闭塞与狭窄程度为50%～74%、75%～99%患者fQRS波检出率间差异有统计学意义(χ2=3.692、9.064,P<0.05)。在狭窄程度为75%～99%和完全闭塞患者中,术后第1天、术后第7天和术前fQRS波检出率间差异均有统计学意义(P<0.05),而术后第7天与术后第1天fQRS波检出率间无统计学意义(P>0.05)。fQRS波的检出率与冠状动脉病变支数的呈正相关(r=0.48,P<0.05),与冠状动脉狭窄程度呈负相关(r=-0.524,P<0.05)。结论 fQRS波可成为预测冠状动脉病变范围和狭窄程度的指标。Objective To explore the correlation between fragmented QRS （fQRS） wave and coronary lesions. Methods 2010--2011, a total of 216 patients with coronary artery disease （CAD） were assigned into an fQRS wave group and a non - fQRS wave group based on the existence of fQRS wave on their electrocardiogram. The range and severity of coronary lesions, influence of culprit vessel on fQRS wave, and the changes of fQRS wave before and after PCI were evaluated. Results No significant difference in fQRS wave detection rate was observed among patients with lesions in different vessels （ P 〉 0. 05 ）. Significant difference in fQRS wave detection rate was observed among patients with different lesion range and stenosis level （ P 〈 0.05 ） ; to be specific, difference was observed among patients of single - vessel CAD, double - vessel CAD, and three - vessel CAD （P 〈 0. 05）, as well as patients with complete occlusion as compared to patients with 50% -74% and 75% - 99% stenosis. （ χ2 = 3. 692, 9. 064 ; P 〈 0.05 ）. Detection rate of fQRS wave was significantly different on day 1 and day 7 after PCI as compared to that before PCI in patients with complete occlusion and/or 75% - 99% stenosis （P 〈 0. 05）, while the difference was not observed between day 1 and day 7 after PCI （ P 〉 0. 05 ）. The detection rate of fQRS wave was positively correlated with range of coronary artery lesions and negatively correlated with the severity of cornoary artery stenosis （ r = 0.48, - 0. 52 ; P 〈 0. 05 ）. Conclusion The fQRS wave can be used as a predictor of the range and severity of coronary artery lesions.

关 键 词：碎裂QRS波 血管成形术 经腔 经皮冠状动脉 冠状动脉疾病 冠状血管造影术 

分 类 号：R541[医药卫生—心血管疾病]