心电图QRS波群时限和急性心肌梗死患者临床病理参数的关系及预后分析  

Relationship between electrocardiogram QRS wave duration and pathological parameters of patients with acute myocardial infarction and prognosis analysis

作　　者：孝俊 李念 柴晓莉 Xiao Jun;Li Nian;Chai Xiaoli(ECG Room,Hunan Brain Hospital,Changsha 410000,China)

机构地区：[1]湖南省脑科医院心电图室,长沙410000

出　　处：《中国医师杂志》2021年第10期1533-1537,共5页Journal of Chinese Physician

摘　　要：目的探讨心电图QRS波群时限和急性心肌梗死患者病理参数的关系及预后分析。方法回顾性选取2018年1月至2019年6月于湖南省脑科医院急诊就诊的急性心肌梗死患者,根据心电图QRS波群时限分为时限正常组(≤110 ms,NG组)和时限延长组(>110 ms,EG组)。收集两组患者的临床病理资料,比较两组患者相关病理参数间的差异,分析心电图QRS波群时限与急性心肌梗死病理参数的相关性,探讨急性心肌梗死后恶性心血管事件发生的独立危险因素。结果入组患者134例,EG组73例,NG组61例。EG组血浆中N-末端脑钠肽前体(N-proBNP)水平显著高于NG组(P<0.05),左室射血分数(LVEF)显著低于NG组(P<0.05),且EG组患者心电图QRS波群时限与血浆中的N-proBNP水平呈正相关(r=0.981,P<0.001),与LVEF呈负相关(r=-0.979,P<0.001)。EG组Killip心功能分级Ⅰ级患者占比少于NG组(P<0.05),Ⅱ级与Ⅲ级患者占比明显多于NG组(P<0.05),两组中Ⅳ级患者占比差异无统计学意义(P>0.05)。EG组患者恶性心血管事件(心源性休克、恶性心律失常、急性肺水肿、心源性死亡、再梗死率及总发生率)发生率明显高于NG组(P<0.05)。多因素logistic回归分析显示患者血浆N-proBNP升高、LVEF下降、心电图QRS波群时限延长、高Killip心功能分级均是急性心肌梗死后恶性心血管事件发生的独立危险因素。结论急性心肌梗死后EG患者较NG患者心功能更差,恶性心血管事件的发生率更高,预后更差。Objective To explore the relationship between electrocardiogram QRS wave duration and pathological parameters of acute myocardial infarction and its prognosis.Methods The patients with a-cute myocardial infarction treated in Hunan Brain Hospital from January 2018 to June 2019 were divided into normal group(≤110 ms,NG group)and extended group(>110 ms,EG group)according to the time limit of QRS wave group of electrocardiogram(ECG).The clinicopathological data of the two groups were collected,and the differences of relevant pathological parameters between the two groups were compared.The correlation between ECG QRS complex time limit and pathological parameters of acute myocardial infarction and the independent risk factors affecting the occurrence of malignant cardiovascular events after a-cute myocardial infarction were analyzed.Results A total of 134 patients were enrolled,73 in the EG group,and 61 in the NG group.The plasma levels of N-terminal pro-brain natriuretic peptide(N-proBNP)in EG group were significantly higher than those in NG group(P<0.05),and left ventricular ejection fraction(LVEF)was significantly lower than that in NG group(P<0.05).The time limit of QRS wave group in EG group was positively correlated with the plasma levels of N-proBNP(r=0.981,P<0.001)and negatively correlated with LVEF(r=-0.979,P<0.001).The ratio of Killip grade I patients in EG group were lower than those in NG group(P<0.05),while-the ratio of gradeⅡandⅢpatients were significantly higher than those in NG group(P<0.05),and there was no significant difference between the two groups in grade IV patients(P>0.05).The incidence of malignant cardiovascular events(cardiogenic shock,malignant arrhythmia,acute pulmonary edema,cardiogenic death and re-infarction)in EG group was significantly higher than that in NG group(P<0.05).Multivariate logistic regression analysis showed Physician,October 2021,VoI.23.No.10 that elevated serum N-proBNP,decreased LVEF,prolonged QRS wave duration and high Killip cardiac function were independent ri

关 键 词：心肌梗死 QRS波群时限 心功能 心血管事件 预后 

分 类 号：R542.22[医药卫生—心血管疾病]