碎裂QRS波评价急性心梗患者预后的临床价值  

The clinical value of the fragmented QRS complex in prognosis after acute ischemic infarction

作　　者：王锐[1] 缪英[1] 郝应禄[1] 管洪[1] 郑丽凤[1] 刘艳超[1] 顾红梅[1] 钱宝堂[1] 刘建平[1] 

机构地区：[1]云南省玉溪市人民医院,653000

出　　处：《临床心电学杂志》2015年第5期338-341,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨碎裂QRS波(fQRS)评价急性心肌梗死患者PCI术后预后的预测价值。方法选取128例AMI患者作为研究对象,PCI术前常规行十二导心电图(ECG)检查和超声心动图检查,根据有无f QRS分为两组,两组患者术后1月、6月跟踪随访ECG及超声心动图,对比两组间fQRS变化及心脏形态功能改变情况,平均随访28±7月,随访两组生存时间,并使用Kaplan-Meier生存分析心血管死亡事件。结果 1fQRS波组中ST抬高型心肌梗死(STEMI)的比例高于无fQRS组,且多支冠脉血管病变较多,两组比较差异有统计学意义(p<0.05);2fQRS组左室舒张末内径(LVEDd)较大,左室射血分数(LVEF)较低,与无fQRS组比较有统计学差异(p<0.05),fQRS组心率变异性(SDNN)值低于无f RQS组,但差异无统计学意义(p>0.05);3Kaplan-Meier生存分析两组AMI患者在随访期间出现的心血管死亡事件,fQRS组生存时间、生存率明显下降,p<0.05。4两组PCI术后1月有LVEF增大及LVEDd的减小,但差异无统计学意义(p>0.05),术后6月,差异有统计学意义(p<0.05),fQRS组少数患者碎裂减轻或消失。结论 fQRS波为评价AMI患者PCI术后的临床预后提供了另一种新的便捷方法。Objective To explore the predictive value of the fragmented QRS complex （fQRS） in patients with acute ischemic infarction （AMI）after percutaneous coronary intervention （PCI）. Methods One hundred and twenty-eight patients with acute ischemic infarction were involved in the study. According to the fragmented QRS complex presenting on the ECG or not, all patients were divided into fQRS group and non- fQRS group after the 12-lead ECG, recording echocardiography before PCI. The index of ECG and enchocardiography were measured in one and six month after PCI, comparing the difference of fQRS and cardiac function as well. Then all patients were followed up for 28 ± 7 months. The cardiac structure and function, survival time, the condition of infarct-related coronary artery as well, were compared between the two groups. And the Kaplan-Meier analysis was explored to assess the cardiac events mortality （the gross causes events mortality）. Results①There were more ST evaluated cardiac infarction patients and more severely infarct-related coronary artery in the fQRS group, comparing with the non-fQRS group （p〈0.05）; ②The end diastolic diameter of the left ventricular was more great and the eject fraction of the left ventricular was much lower in the fQRS group than those in non-fQRS group. The difference between the two groups was significant （p 〈0.05）. Though the SDNN was very low in the fQRS group, the SDNN between the groups was no significant （p〉0.05）; ③Employing the Kaplan-Meier method to analyze the gross causes mortality in the following period, the survive time and the survive rate decreased severely in the fQRS group （p〈0.05）; ④One month After PCI, the LVEF increased and the LVEDd decreased in the fQRS group, but the significance between the two group was no obvious （p〉0.05）. Although six month after, there was much significant between the two group （p〈0.05）. And the fQRS form of some patients reduced or disappeard. Conclusions The fragmented QRS complex pro

关 键 词：碎裂QRS波 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]