ST段抬高型急性心肌梗死患者QRS波积分表达水平对预后影响效果分析  

Effect analysis of the QRS wave integral expression level on prognostic impact of the acute ST segment elevated myocardial infarction patient

作　　者：张琦 马卓 周游 吴迪 

机构地区：[1]煤炭总医院心血管内科,北京市100028 [2]华北理工大学研究生院

出　　处：《中国心血管病研究》2017年第4期317-320,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨QRS波积分变化对ST段抬高型急性心肌梗死患者预后的影响.方法 回顾性调查我院收治的80例确诊STEMI患者,根据ECG检查结果,将48例ST段抬高而QRS波群终末未发生改变者归为A组,将32例ST段抬高,QRS波群出现终末变形患者归为B组.比较两组患者QRS波积分、心功能相关指标、随访6个月心血管事件发生情况,以及QRS积分与cTnI、CK-MB峰值、BNP、LVEF、LVED的相关关系.结果 ①两组心功能分级构成存在显著性差异,A组心功能Ⅰ级患者占56.25％（27/48）远高于B组31.25％（10/32） （P＜0.05）;A组前壁心梗占58.33％（28/48）,B组下壁心梗占50％（16/32）,两组心肌梗死分布存在显著性差异（P＜0.05）;A组心率、cTnI、CK-MB、BNP指标值明显低于B组,而LVEF、LVED分值明显高于B组,同时A组QRS积分明显低于B组（P＜0.05）.②随访6个月,A组心血管事件发生率为4.17％（2/48）,远低于B组37.50％（12/32）.③QRS积分与cTnI、CK-MB峰值、BNP、心血管事件发生呈正相关;QRS积分与LVEF、LVED呈负相关.结论 QRS积分能较好地反映患者心功能状况,QRS积分越低,STEMI患者预后水平越好.Objective To explore the effect of the QRS wave integral expression level on prognostic impact of the acute ST segment elevated myocardial infarction patient.Methods 80 cases of STEMI patients were retrospectively surveyed in our hospital,according to the results of ECG examination,48 cases with ST elevation and no change in the end of the QRS wave group were classified as group A,32 cases with ST elevation and changes in the end of the QRS wave group were classified as group B.The QRS wave scores,cardiac function related indicators and follow-up of cardiovascular events in 6 months of the two groups Were compared,and the correlation of QRS integration with cTnI,CK-MB peak,BNP,LVEF,LVED were analyzed.Results （1）There were significant differences between A and B groups in the classification of cardiac function,the Cardiac function grade Ⅰ patients accounted for 56.25%（27/48） in group A,which was higher than the results of group B with 31.25% （10/32）;the anterior wall myocardial infarction accounted for 58.33%（28/48） in Group A,which was higher than the results of group B with 50%（16/32）;the heart rate,cTnI,CK-MB,BNP index values of group A were significantly lower than the group B,the values of LVEF,LVED of group A were higher than the group B,the QRS score of A group was significantly lower than that of control group （P〈O.05）.（2）With the result of follow up for 6 months,the incidence of cardiovascular events in group A was 4.17%（2/48）,which was much lower than that of the incidence of cardiovascular events in group A was 4.17%（2/48）,which was much lower than 37.50% （12/32） in group B.（3）QRS score was positively correlated with cTnI,CK-MB peak,BNP,cardiovascular events,and was negatively correlated with the value of LVED,LVEF.Conclusion The QRS score will better reflect the heart function condition,in which the lower the QRS score,the better the prognosis of patients with STEMI.

关 键 词：急性心肌梗死 ST段抬高 QRS积分 心电图 预后 

分 类 号：R542.22[医药卫生—心血管疾病]