比索洛尔干预对于ACS患者急诊PCI术后QRS-T夹角改变及其临床意义研究  

Influence of Bisoprolol Intervention on QRS-T Angle in ACS Patients after Emergency PCI Treatment and Its Clinical Significance

作　　者：陈海威[1] 李娜[1] 王磊[1] 翟红霞[1] 夏云峰[1] 

机构地区：[1]解放军总医院第一附属医院干一科,北京100048

出　　处：《现代生物医学进展》2017年第1期84-87,共4页Progress in Modern Biomedicine

基　　金：全军后勤科研计划面上项目(CWS14J070)

摘　　要：目的:探讨比索洛尔干预对于急性冠脉综合征(acute coronary syndrome,ACS)患者急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后QRS-T转角改变及其临床意义。方法:连续纳入100例ACS患者,急诊PCI术开通罪犯血管,术后分为比索洛尔组和常规治疗组。另选50名年龄相似,非冠心病志愿者作为对照组。观察术前和术后额面QRS-T夹角情况与术后1年主要心脏不良事件(major adverse cardiovascular events,MACE)发生率的相关性。结果:ACS患者PCI术前额面QRS-T夹角均明显高于对照组(F=4.528,P=0.033)。在急诊PCI后第三天可见比索洛尔组ACS患者额面QRS-T夹角明显回落(74.9±11.2°vs.50.3±15.2°,P<0.05)。比索洛尔治疗与ACS患者急诊PCI术后额面QRS-T夹角改变(r=0.783,P=0.013)成正相关,而与MACE发生率(r=-0.512,P=0.034)存在负相关。ACS患者急诊PCI术后使用早期加用比索洛尔治疗后可以使MACE发生风险降低23%(P=0.012)、△额面QRS-T夹角(每增加1°)使MACE风险降低8%(P=0.041),而Gensini评分(每增加1分)使MACE发生风险升高32%(P=0.035)。结论:ACS患者PCI术后早期应用比索洛尔治疗可以促进额面QRS-T夹角水平回落。额面QRS-T夹角回落幅度与MACE的发生相关。Objective： To evaluate the influence of Bisoprolol intervention on QRS-T angle in patients with acute coronary syndrome（ACS） after emergency percutaneous coronary intervention（PCI） and its clinical significance. Methods： 100 ACS patients were consecutively enrolled into the study and divided into Bisoprolol group and normal treatment group after PCI. Another 50 age-matched and non-coronary heart disease cases were enrolled at the same time as control group. The QRS-T angel before and after the intervention and their correlation with the incidence of major adverse cardiovascular events（MACE） one year after PCI. Results： Before the treatment,ACS patients showed a higher level of QRS-T angle compared with controls. Levels of QRS-T angle in bisoprolol group showed a significant reduction on the third day after PCI treatment compared with those in normal treatment group（74.9 ±11.2° vs. 50.3±15.2°,P〈0.05）. Correlation analysis showed that bisoprolol treatment was positively associated with changes of QRS-T angle（r=0.783, P=0.013）, while negatively related with MACE incidence rate（r=-0.512, P=0.034）. Logistic regression analysis showed that bisoprolol administration during early stage after PCI of ACS patients can decrease MACE incidence rate 23%（P=0.012）, △QRS-T angle（per 1°） could decrease MACE incidence rate 8%（P=0.041）, and Gensini score could make MACE incidence rate increase 32%（P=0.035）. Conclusion：Early bisoprolol treatment may enhance the reduction of QRS-T angle in ACS patients following PCI. The range of QRS-T angle is associated with occurrence rate of MACE.

关 键 词：比索洛尔 急性冠脉综合征 PCI术 QRS-T夹角 

分 类 号：R541.4[医药卫生—心血管疾病]