陈旧性心梗患者经QRS波时限预测室性心律失常  

The study on the relationship between QRS duration and ventricular arrhythmias in old myocardial infarction(OMI) patients

作　　者：马淑英[1] 杨文波[1] 吕金兰[1] 张媛[1] 王乐信 马龙乐[1] 

机构地区：[1]山东聊城市人民医院,252000 [2]澳大利亚查尔斯特大学心血管病研究中心(澳大利亚及纽西兰心脏病学院)

出　　处：《临床心电学杂志》2014年第5期341-344,共4页Journal of Clinical Electrocardiology

摘　　要：目的通过分析陈旧性心肌梗死(OMI)患者病理性Q波、碎裂QRS波(f QRS)及其与室性心律失常的发生情况,探讨病理性Q波及f QRS与室性心律失常的关系。方法对335例确诊陈旧性心肌梗死的患者进行动态心电图检查,将OMI伴f QRS波患者按照f QRS波时限分为f QRS≥110ms组(36例)、f QRS<110ms(156例),并对两组间室性心律失常发生率进行对比分析;将OMI伴病理性Q波患者按照病理性Q波QRS波群时限分为QRS≥110ms组(21例)、QRS<110ms(75例),并对两组间室性心律失常发生率进行对比分析。结果OMI伴f QRS波患者f QRS≥110ms组室性心动过速发生率明显高于f QRS<110ms(p=0.026);OMI伴病理性Q波患者QRS≥110ms组成对室性期前收缩(p=0.045)及室性逸搏心律(p=0.026)发生率明显高于QRS<110ms组。结论 OMI伴f QRS患者随着f QRS时限延长,发生室性心动过速的风险随之增高;OMI伴病理性Q波患者随着QRS波时限延长,发生成对室性期前收缩及室性逸搏心律的风险随之增高。Objective By analyzing the incidence of QRS fragmentation wave （fQRS）,pathological Q waves and ventricular arrhythmias in patients with old myocardial infarction （OMI）,to explore the relationship between fQRS and pathological Q waves with ventricular arrhythmias.Methods The Hoher was obtained from all 335 patients with definite ventricular arrhythmias.According to fQRS wave duration,OMI patients with fQRS were divided into fQRS ≥ 110ms group （36）,fQRS ＜110ms group （156）,and the incidence of ventricular arrhythmias between the two groups were analyzed.According to QRS wave duration of pathologic Q waves,OMI patients with pathologic Q wave were divided into QRS ≥ 110ms group （21）,QRS ＜110ms group （75）,and the incidence of ventricular arrhythmias between the two groups were analyzed.Results The incidence of ventricular tachycardia in QRS ≥ 110ms group of OMI patients with fQRS is significantly higher than QRS ＜ 110ms group of OMI patients with fQRS （p=0.026）; The incidence of paired ventricular premature contractions （p=0.045） and ventricular escape rhythm （p=0.026） in QRS ≥ 110ms group of OMI patients with pathologic Q wave is significantly higher than QRS ＜ 110ms group of OMI patients with pathologic Q wave.Conclusions The longer fQRS duration of OMI patients with fQRS,the higher the risk of ventricular tachycardia; and the longer QRS duration of OMI with pathological Q wave,the higher the risk of paired ventricular premature contractions and ventricular escape rhythm.

关 键 词：QRS时限 陈旧性心肌梗死 碎裂QRS波 病理性Q波 

分 类 号：R542.2[医药卫生—心血管疾病]