非ST段抬高型心肌梗死的病理性Q波与碎裂QRS波的诊断预测价值对比分析  

Comparative Analysis of Diagnostic Predictive Value of Pathological Q Wave and Fragmented QRS Wave of Non-ST Segment Elevation Myocardial Infarction

作　　者：谢福生[1] 莫新玲[2] 陈健中[2] 夏中华[1] 李全忠[2] 

机构地区：[1]桂林医学院第二附属医院心内科,广西桂林541199 [2]桂林医学院附属医院心内科,广西桂林541199

出　　处：《中外医疗》2016年第14期191-192,195,共3页China & Foreign Medical Treatment

基　　金：2009年广西卫生厅自筹经费计划课题(Z2009056)

摘　　要：目的探究非ST段抬高型心肌梗死的病理性Q波与碎裂QRS波的诊断预测价值。方法研究对象为整群选取2013年7月—2015年9月之间该院收治的74例非ST段抬高型心肌梗死(NSTEMI)患者,根据入院3 d内的12导联心电图检查结果将其分为碎裂QRS波32例,病理性Q波12例,以及单纯ST段改变者30例,对NSTEMI患者的碎裂QRS波和病理性Q波的发生率、敏感性、特异性进行统计对比。结果该组患者中碎裂QRS波发生率为43.2%,显著高于病理性Q波的16.2%,差异具有统计学意义(P<0.05);碎裂QRS波的敏感性及特异性分别为43.2%和94.2%,与病理性Q波的16.2%和89.5%相比,碎裂QRS波的敏感性更高(P<0.05),但两者的特异性对比差异无统计学意义(P>0.05)。结论在非ST段抬高型心肌梗死患者的诊断中,碎裂QRS波可作为心电图诊断的一个新指标,能够提高急性心肌梗死患者的诊断率,值得在临床上推广和应用。Objective To discuss the diagnostic predictive value of pathological Q wave and fragmented QRS wave of nonST segment elevation myocardial infarction. Methods 74 cases of patients with non-ST segment elevation myocardial infarction admitted and treated in our hospital from July 2013 to September 2015 were selected as the research objects and divided into the fragmented QRS wave group with 32 cases, pathological Q wave group with 12 cases and simple ST segment change group with 30 cases according to the 12 lead electrocardiogram examination results in 3d after admission,and the incidence rate, sensitivity and specificity of the pathological Q wave and fragmented QRS wave in patients with NSTEMI were counted and compared. Results The incidence rate of the fragmented QRS wave was obviously higher than that of the pathological Q wave（43.2% vs 16.2%）, and the difference had statistical significance（P〈0.05）, the sensitivity of the fragmented QRS wave was higher than that in the pathological Q wave group,（43.2% vs 16.2%）（P〈0.05）, but there was no obvious difference in the specificity between the two groups（94.2% vs 89.5%）（P〉0.05）. Conclusion Fragmented QRS wave can be used as a new index of the electrocardiogram diagnosis in diagnosis of the patients with non-ST segment elevation myocardial infarction, which can improve the diagnosis rate of patients with acute myocardial infarction, and it is worth clinical promotion and application.

关 键 词：心肌梗死 心电图 碎裂QRS波 病理性Q波 

分 类 号：R542.22[医药卫生—心血管疾病]