经PCI治疗ST段抬高心梗患者QRS宽度与心肌呈色分级关联  

Association Between QRS Duration and Myocardial Blush Grade in ST-segment Elevation Myocardial Infarction Patients Treated by PCI

作　　者：夏玉锟 XIA Yu-kun(Department of Geriatrics, General Hospital of Datong Coal Mine Group Co., Datong Shanxi, 037003;The Second Affiliated Hospital of Shanxi Datong University, Datong Shanxi, 037003)

机构地区：[1]大同煤矿集团有限责任公司总医院老年病科 [2]山西大同大学附属第二医院

出　　处：《山西大同大学学报（自然科学版）》2019年第4期56-58,68,共4页Journal of Shanxi Datong University(Natural Science Edition)

摘　　要：目的评价经皮冠状动脉介入(PCI)治疗ST段抬高型心肌梗死(STEMI)患者QRS宽度与心肌呈色分级(MBG)的关系。方法对100例12h内就诊的STEMI患者进行术前和术后心电图分析,根据MBG分为2个研究组:A组(MBG0-1)(n=40)和B组(MBG2~3)(n=60)。结果2组患者基线特征相似。在血管成形术后即刻心电图(95.56±15.63vs80.87±12.80ms,P<0.001)和60min心电图(96.95±16.24vs78.82±12.08ms,P<0.001)检测中,A组QRS持续时间均比B组长。2组血管成形术后即刻(10.99±10.05vs6.64±10.61ms,P<0.00)和60min心电图(13.03±11.64vs7.95±11.11ms,P<0.001)QRS宽度差别有显著性差异。ROC曲线分析显示血管成形术后60minQRS变窄可预测心肌再灌注。结论STEMI患者血管成形术后QRS宽度变窄与心肌再灌注密切相关。To assess the relationship between measurements of QRS duration and myocardial blush grade (MBG) in patients with ST-elevation myocardial infarction(STEMI) who were treated with a primary percutaneous coronary intervention (PCI). Methods From January 2016 to June 2018, 100 patients with STEMI who presented within 12 h of symptom onset and taken up for primary PCI were analyzed with electrocardiogram (ECG) before and after the procedure. Two study groups were then defined on the basis of MBG: group A (MBG 0-1)(n=40) and group B (MBG 2-3)(n=60). Results The baseline characteristics were similar in the two groups. QRS duration was found to be longer in group A compared with group B at both the immediate ECG (95.56 ± 15.63 vs 80.87 ± 12.80 msec, P < 0.001, respectively) and at the 60th minute ECG (96.95 ± 16.24 vs 78.82 ± 12.08 msec, P < 0.001, respectively) post angioplasty. Significant difference was detected between the two groups post-angioplasty at both the immediate (10.99 ± 10.05vs 6.64 ± 10.61 msec, P< 0.001) and the 60th minute (13.03 ± 11.64 vs 7.95 ± 11.11 msec, P < 0.001)ECG. Using receiver operator curve analysis, we found that QRS complex narrowing of 60 min post angioplasty was the best value for predicting reperfusion. Conclusion QRS duration change post angioplasty is strongly correlated with the myocardial reperfusion in patients presenting with STEMI.

关 键 词：ST段抬高型心肌梗死 QRS波 心肌呈色分级 

分 类 号：R541.4[医药卫生—心血管疾病]