冠状动脉狭窄>70%的心绞痛患者心电图QRS碎裂波出现的危险因素分析  

Risk factors of occurrence of fragmented QRS complexes in angina pectoris patients with coronary artery stenosis>70%

作　　者：张明磊 杨清泉[1] 李贞彩[1] 王星[1] 张一帆 Zhang Minglei;Yang Qingquan;Li Zhencai;Wang Xing;Zhang Yifan(Department of General Medicine,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院全科医学科,473000

出　　处：《中国实用医刊》2020年第13期40-43,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究冠状动脉狭窄>70%的心绞痛患者心电图QRS碎裂波出现的相关危险因素。方法抽取2018年7月至2019年10月南阳市中心医院心血管内科收治的230例冠状动脉狭窄>70%的心绞痛患者为研究对象。经十二导联同步心电图检查,存在心电图QRS碎裂波者为观察组(70例),无心电图QRS碎裂波者为对照组(160例)。观察两组临床资料、心电参数和超声结果,分析上述指标与QRS碎裂波的关系。结果观察组年龄、空腹血糖(FPG)水平高于对照组,差异有统计学意义(P<0.05)。观察组QRS波时限、左室舒张末期内径(LVEDD)、右房内径(RAD)高于对照组,左室射血分数(LVEF)低于对照组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,年龄、FPG、QRS波时限、LVEDD、LVEF、RAD与QRS碎裂波呈正相关(P<0.05),而房性早搏、室性早搏与QRS碎裂波无相关性(P>0.05)。多因素Logistic回归分析显示,年龄较大、FPG水平升高、QRS波时限延长、LVEDD增加、LVEF降低是冠状动脉狭窄>70%的心绞痛患者心电图QRS碎裂波出现的独立危险因素(P<0.05)。结论年龄较大、FPG水平升高、QRS波时限延长、LVEDD增加、LVEF降低是冠状动脉狭窄>70%的心绞痛患者出现心电图QRS碎裂波的重要危险因素,相关人群应引起重视并加强行为干预和临床治疗。Objective To investigate the risk factors of occurrence of fragmented QRS complexe (fQRS) in angina pectoris patients with coronary stenosis> 70%.Methods A total of 230 angina pectoris patients with coronary stenosis>70% who were treated in Department of Cardiovascular Medicine, Nanyang Central Hospital from July 2018 and October 2019 were enrolled. According to results of 12-lead synchronous electrocardiogram (ECG) examination, patients who had fQRS were selected as the observation group (70 cases), and patients without fQRS were selected as the control group (160 cases). The clinical data, ECG parameters and ultrasound results of the two groups were observed, and their relationships with fQRS were analyzed.Results The ages and fasting blood glucose (FPG) levels in the observation group were higher than those in the control group (P<0.05). The fQRS time limit, left ventricular end-diastolic dimension (LVEDD), and right atrial dimension (RAD) of the observation group were higher than those of the control group, while the left ventricular ejection fraction (LVEF) was lower than that of the control group (P<0.05). Spearman correlation analysis showed that age, FPG, fQRS time limit, LVEDD, LVEF and RAD were positively correlated with fQRS (P<0.05), but atrial premature beat and ventricular premature beat had no significant correlation with fQRS (P>0.05). Multivariate logistic regression analysis revealed that old age, increased FPG levels, longer QRS time limit, increased LVEDD and decreased LVEF were independent risk factors for fQRS in angina pectoris patients with coronary stenosis>70% (P<0.05).Conclusions Old age, increased FPG levels, longer QRS time limit, increased LVEDD and decreased LVEF are important risk factors for the occurrence of fQRS in angina pectoris patients with coronary stenosis>70%. The relevant groups should be paid attention, for which strengthened intervention and clinical treatment should be performed.

关 键 词：心绞痛 冠状动脉狭窄 QRS碎裂波 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]