早期心电图QRS波宽度对急性ST段抬高型心肌梗死患者心脏不良事件的影响  

Effects of Early Electrocardiographic QRS Width on Recent Major Adverse Cardiac Events in Patient with Acute ST-segment Elevation Myocardial Infarction

作　　者：金德奎 於四军[1] 王文启[1] 吴雨径 刘惠亮[1] 

机构地区：[1]武警总医院心血管内科,北京100853 [2]武警后勤学院,天津300300

出　　处：《现代生物医学进展》2016年第15期2949-2952,共4页Progress in Modern Biomedicine

基　　金：卫生部医药卫生科技发展项目(W2013GJ09)

摘　　要：目的：探讨早期心电图QRS波宽度（QRSw）对急性ST段抬高型心肌梗死（STEMI）患者近期主要心脏不良事件（MACE）的影响。方法：选取我院收治的135例STEMI患者为研究对象,按照入院时的心电图QRSw将患者分为A组（QRSw为60 ms≤QRSw≤80 ms）、B组（QRSw为80 ms，Objective： To explore the effects of early electrocardiographic QRS width（QRSw） on recent major adverse cardiac events（MACE） in patient with acute ST-segment elevation myocardial infarction（STEMI）. Methods： A total of 135 cases of STEMI patients in our hospital from June 2014 to June 2015 were selected as the research subjects. All patients were divided into group A（QRSw：60ms≤QRSw≤80 ms）, group B（QRSw： 80 msQRSw100 ms）, group C（QRSw： QRSw≥100 ms） according to QRSw on admission. Meanwhile, all patients were divided into MACE group and non-MACE group according to MACE in hospitalization. Related indexes were compared between the groups, and multivariable logistic regression model was used to analyze the relationship of QRSw with MACE. Results： There were statistically significant differences in infarction area, CK-MB, c Tn I, BNP, hs-CRP and LVEF between group A, B and C（P〈0.05）. The CK-MB, c Tn I, BNP, hs-CRP levels were higher in group C than in group A and B, and the infarction area was larger, and LVEF was lower in group C. There were also statistically significant differences in incidence of MACE between three groups（P〈0.05）. The incidence of group C was higher than those of group A and B. QRSw of MACE group was longer than that of non MACE group（P〈0.05）, and the proportion of patients with QRSw≥100ms in MACE group was higher than that of non MACE group（P〈0.05）.Multivariable logistic regression analysis showed that QRSw（OR=1.214, CI： 1.104~1.441, P〈0.05） was independent risk factor of MACE. Conclusion： The risk of MACE increased with the increasing of QRSw. QRSw may be an independent risk factor for recently occurred MACE in STEMI patients, and should be pay more clinical attentions.

关 键 词：ST段抬高型心肌梗死 QRS波宽度 主要心脏不良事件 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]