非下壁陈旧性心肌梗死致下壁导联碎裂QRS波的分析探讨  

The fragmented QRS of inferior leads in patients with old non-inferior myocardial infarction

作　　者：杨文波[1] 吕金兰[2] 马淑英[2] 王英丽[1] 张媛[2] 黄广勇[1] 贾嫄[1] 

机构地区：[1]泰山医学院聊城临床学院聊城市人民医院心内科,山东省聊城市252000 [2]泰山医学院聊城临床学院聊城市人民医院心电图室,山东省聊城市252000

出　　处：《中国心血管病研究》2014年第7期587-590,共4页Chinese Journal of Cardiovascular Research

基　　金：山东省医药卫生科技发展计划项目（项目编号：2009HZ015

摘　　要：目的 探讨非下壁陈旧性心肌梗死（OMI）患者下壁导联碎裂QRS波（fQRS）发生率,并与胸前导联碎裂QRS波发生率进行对比.方法 选择173例陈旧性前间壁（119例）、前壁（44例）、广泛前壁（10例）心肌梗死患者进行静息心电图检查,根据fQRS的有无分为有fQRS组和无fQRS组;根据fQRS所在导联位置,分为Ⅱ导联fQRS组、Ⅲ导联fQRS组、aVF导联fQRS组、≥2个下壁导联fQRS组、≥2个胸前导联fQRS组,并对各组数据进行统计分析.结果 ①前间壁、前壁、广泛前壁三组间fQRS发生率存在明显差异（P=0.008）,其中广泛前壁发生率为100％,前壁组fQRS发生率明显高于前间壁组（P=0.014）.②前间壁、前壁、广泛前壁三组间单一下壁导联、≥2个下壁导联及≥2个胸前导联的fQRS发生率差异均无统计学意义（P＞0.05）;前间壁、前壁、广泛前壁各组内不同下壁导联间fQRS发生率无明显差异（P＞0.05）.③前间壁组内比较,≥2个下壁导联的fQRS发生率明显高于≥2个胸前导联（P=0.045）;前壁组内比较,≥2个胸前导联的fQRS发生率明显高于≥2个下壁导联（P=0.048）.结论 心电图fQRS的形成与心肌梗死的部位有关,且广泛前壁心梗者最易形成fQRS,前壁及前间壁心梗者次之.前壁OMI患者梗死部位相关导联更易出现fQRS,面前间壁OMI患者更易在下壁导联出现fQRS.下壁导联fQRS波形成可能预示着下壁或者前间壁血管或心肌的相关病变.Objective To investigate the inferior leads fragmented QRS（fQRS） incidence in patients with old non-inferior myocardial infarction,and compare it with the precordial leads.Methods 173 patients with old anteroseptal （119 patients）,anterior （44 patients） and extensive anterior （10 patients） myocardial infarction were investigated.According to the leads of fQRS,they were divided into lead Ⅱ group,lead Ⅲ group,lead aVF group,≥ 2 inferior leads group and ≥ 2 precordial leads.The statistics of each group were collected and analyzed.Results （1）The fQRS incidence among anteroseptal group,anterior group,and extensive anterior group had significantly difference （P=0.008）.The fQRS incidence in extensive anterior group was 100％.That in anterior group was significantly higher than anteroseptal group （P=0.014）.（2）Among anteroseptal group,anterior group,and extensive anterior group,fQRS incidence of single inferior lead,≥ 2 inferior leads and ≥ 2 precordial leads had no significant difference（P＞0.05）.The fQRS incidence among different inferior leads in each group did not differ（P＞ 0.05）.（3）In the anteroseptal group,the fQRS incidence of ≥2 inferior leads was significantly higher than that of ≥2 precordial leads（P=0.045）.In the anteroseptal group,the fQRS incidence of ≥2 an precordial leads was significantly higher than that of ≥2 inferior leads （P=0.048）.Conclusion The performance of fragmented QRS is connected with the location of myocardial infarction.In general,the fQRS incidence in patients with extensive anterior myocardial infarction is significantly higher than that in anterior and inferior myocardial infarction.The patients with anterior myocardial infarction usually have fQRS in the precordial leads.However,the performances of fQRS in patients with anteroseptal myocardial infarction are often found in the inferior leads.So the performance of fQRS in the inferior leads may imply the pathological changes of inferior or anteroseptal arteries and

关 键 词：陈旧性心肌梗死 碎裂QRS波 

分 类 号：R542.22[医药卫生—心血管疾病]