心肌梗死QRS波终末变形与冠脉血管病变及hs-cTnI的关系  

Relationship between QRS wave terminal distortion with coronary arterial lesion and serum hs-cTnI in acute ST-segment elevation myocardial infarction

作　　者：张琴[1] 杨苏萍[1] 秦国伟[1] 张雅莉[1] 陈晓婕[1] 卢志红[1] 杨霞芳[1] 洪基格 吴洁[1] 

机构地区：[1]广西壮族自治区人民医院心血管内科,南宁530021

出　　处：《重庆医学》2017年第25期3512-3514,共3页Chongqing medicine

基　　金：广西医疗卫生适宜技术研究与开发计划课题(桂卫S201314-02);广西科学研究与技术开发计划项目(2014BC16);广西自然科学基金面上项目(2014GXNSFAA118274)

摘　　要：目的探讨早期急性ST段抬高型心肌梗死(STEMI)患者心电图QRS波终末变形与冠脉血管病变和血清高敏肌钙蛋白I(hs-cTnI)的关系。方法根据入院心电图将120例STEMI患者分为QRS波终末变形(QRS+)组81例和无QRS波终末变形(QRS-)组39例,两组均行冠脉造影及检测hs-cTnI。比较两组冠脉血管病变发生情况和hs-cTnI水平。结果(1)QRS+组:男68例(83.95%),女13例(16.05%);QRS-组:男27例(69.23%),女12例(30.77%),两组性别比较差异有统计学意义(P<0.05)。(2)QRS+组患者左前降支病变发生率高于QRS-组,差异有统计学意义(P<0.05),QRS-组患者左回旋支病变发生率高于QRS+组,差异有统计学意义(P<0.01)。(3)QRS+组患者hs-cTnI的水平高于QRS-组,差异有统计学意义(P<0.01)。结论 QRS波终末变形者左前降支病变发病率高、QRS波终末无变形者左回旋支病变发病率高;QRS波终末变形与血清hs-cTnI水平有关。Objective To investigate the relationship between QRS wave terminal distortion with coronary arterial lesion and serum high-sensitivity cardiac troponin I （ hs-cTnI ） in early stage of acute ST-segment elevation myocardial infarction （STEMI）. Methods One hundred and twenty patients with STEMI were classified into the QRS wave distortion positive group（QRS＋ ,n= 81） and non- QRS wave distortion group（QRS-- group,n=39） according to EKG on admission. The two groups all conducted the coronary angiography and hs-cTnI detection. The coronary arterial lesion occurrence situation and hs-cTnI level were compared between the two groups. Results （1） In the QRS＋ group：68 cases （83.59%） were male and 13 cases （16.05%） were females;in the QRS- group：27 cases（69.23 %） were male and 12 cases （30.77 %） were female. The sex difference had statistical significance （P〈0.05）. （2） The occurrence rate of left anterior descending artery （LAD） lesion in the QRS＋ group was higher than that in the QRS- group,the difference was statistically significant （P〈0.05）. But the occurrence rate of left circumflex coronary artery （LCX） lesion in the QRS- group was higher than that in the QRS＋ group,the difference was statistically significant （P〈0.01）. （3） The hs-cTnI level in the QRS＋ group was higher than that in the QRS- group,the difference was statistically significant （P 〈0.01）. Conclusion The patients with QRS wave distortion positive have a higher occurrence rate of LAD lesion,while the pa- tients with out QRS wave distortion negative have higher occurrence rate of LCX lesion;the QRS wave terminal distortion has rela- tionship with serum hs-cTnI level.

关 键 词：心肌梗死 QRS波终末变形 高敏肌钙蛋白I 

分 类 号：R542.22[医药卫生—心血管疾病]