碎片状QRS波群在老年高血压患者早期心脏损伤中的临床意义  

The clinical significance of fragmented QRS complex in the early heart injury in elderly hypertensive patients

作　　者：汤爱芳[1] 朱凌燕[2] Tang Aifang;Zhu Lingyan(Second Ward,Department of Geriatrics,The Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai,200233,P.R.China;Department ofNursing,TheSixthPeople'sHospitalAffiliatedtoShanghai JiaotongUniversity,Shanghai,200233,P.R.China)

机构地区：[1]上海交通大学附属第六人民医院老年病科二病区,上海200233 [2]上海交通大学附属第六人民医院护理部,上海200233

出　　处：《老年医学与保健》2021年第2期296-299,共4页Geriatrics & Health Care

基　　金：上海第六人民医院院级课题(院内-2153)。

摘　　要：目的探讨碎片状QRS波群在老年高血压患者早期心脏损伤中的临床意义。方法选取2017年6月-2020年6月上海交通大学附属第六人民医院住院患者120例,根据有无碎片状QRS波群将患者分为观察组(n=28,有碎片状QRS波群)及对照组(n=92,无碎片状QRS波群)。评估并比较2组患者心肌损伤标志物的水平:氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I (cTnI)和肌酸激酶同工酶(CK-MB)以及心肌肌钙蛋白(cTnT);比较2组患者心电图表现及动态心电图结果。结果观察组患者年龄大于对照组,且合并高脂血症的比例及他汀类药物使用率均高于对照组,差异有统计学意义(P<0.05);2组性别、BMI及其他用药情况差异无统计学意义(P>0.05);观察组患者血清NT-proBNP、cTnl、CK-MB、cTnT水平高于对照组,差异均有统计学意义(P<0.05);观察组患者P波增宽率及双峰率均明显高于对照组(39.3% 10.9%、42.9% 14.1%,P<0.05);2组间ST-T改变及左室肥大率差异均无统计学意义(P>0.05);观察组患者心律失常发生率高于对照组(53.6% vs 30.4%,P<0.05)。结论碎片状QRS波群与老年高血压早期心脏损伤相关,有潜在的临床诊断价值。Objective To explore the clinical significance of fragmented QRS complex in the early heart injury in elderly hypertensive patients.Methods A total of 120 inpatients in the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University from June 2017 to June 2020 were selected and were divided into observation groups(n=28,with fragmented QRS complex) and control group(n=92,without fragmented QRS complex) according to the presence or absence of fragmented QRS complex.The levels of myocardial injury markers,including N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnl),creatine kinase isoenzyme(CK-MB) and cardiac muscle calcium protein(cTnT),and the ECG performance and dynamic ECG results were evaluated and compared between the two groups.Results The patients in the observation group were older than those in the control group and the proportion of hyperlipidemia and statin use rate in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).There were no significant differences in gender,BMI and other medication conditions between the two groups(P>0.05).The levels of serum NTproBNP,cTnI,CK-MB,cTnT of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).The P-wave broadening rate and double peak rate in the observation group were significantly higher than those in the control group(39.3% vs 10.9%、42.9% vs 14.1%,P<0.05).There was no statistical difference in the rate of left ventricular hypertrophy and the ST-T changes between the two groups(P>0.05).The incidence of arrhythmia in the observation group was higher than that in the control group(53.6% vs 30.4%,P<0.05).Conclusion Fragmented QRS complex is associated with early cardiac injury in elderly patients with hypertension and has potential clinical diagnostic value.

关 键 词：老年 高血压 碎片状QRS波群 早期心脏损伤 

分 类 号：R544.1[医药卫生—心血管疾病]