急性冠脉综合征患者12导联体表心电图碎裂QRS复合波与肌钙蛋白Ⅰ的相关性  

Correlation between 12 lead surface electrocardiogram fragmented QRS(fQRS) complex and troponinⅠ(trop-Ⅰ)in patients with acute coronary syndrome

作　　者：滕瑾 龚城妙 薛芳 TENG Jin;GONG Chengmiao;XUE Fang(Department of Electrocardiology,Jinhua People's Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市人民医院心电生理科,浙江金华321000

出　　处：《中国现代医生》2023年第5期47-51,共5页China Modern Doctor

摘　　要：目的探讨急性冠脉综合征(acute coronary syndrome,ACS)患者12导联体表心电图碎裂QRS(fragmented QRS,fQRS)复合波与心肌肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)的相关性。方法选择2019年1月至2021年12月在金华市人民医院行经皮冠脉介入术治疗的417例心肌梗死患者,其中ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)298例,非ST段抬高型心肌梗死(non-ST segment elevation myocardial infarction,NSTEMI)119例。收集所有患者的初始12导联心电图fQRS发生率和cTnⅠ水平,采用多元线性回归相关评估fQRS和cTnⅠ间的相关性,采用Cox回归分析评估主要心血管不良事件(major adverse cardiovascular events,MACE)的独立因素。结果共有173例患者出现fQRS,发生率为41.49%。fQRS阳性患者cTnⅠ水平显著高于cTnⅠ阴性患者(P<0.05),STEMI和NSTEMI患者的fQRS阳性率比较,差异无统计学意义(P>0.05);fQRS阳性患者左心射血分数(left ventricular ejection fractions,LVEF)显著低于fQRS阴性患者,左室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心房直径显著高于fQRS阴性患者(P<0.05)。多元线性分析结果显示fQRS和cTnⅠ呈显著正相关(P<0.05)。多因素Cox回归分析结果显示,fQRS是主要心血管不良事件的独立预测因素(P<0.05)。结论ACS患者fQRS与cTnⅠ显著相关,fQRS是主要心血管不良事件的独立预测因素。Objective To investigate the correlation between fragmented QRS(fQRS)complex waves and cardiac troponinⅠ(cTnⅠ)on 12-lead body surface electrocardiogram(ECG)in patients with acute coronary syndrome.Methods A total of 417 patients with myocardial infarction who underwent percutaneous coronary intervention in Jinhua People’s Hospital from January 2019 to December 2021 were selected,including 298 cases of ST segment elevation myocardial infarction(STEMI)and 119 cases of non-ST segment elevation myocardial infarction(non-STEMI).The incidence of initial 12-lead ECG fQRS and cTnⅠlevels were collected from all patients.Correlation between fQRS and cTnⅠwas assessed using multiple linear regression correlation and independent factors for major adverse cardiovascular events(MACE)were assessed using Cox regression analysis.Results Among 417 patients,173 patients developed fQRS,with an incidence of 41.49%.The level of cTnⅠin fQRS positive patients was significantly higher than that in cTnⅠnegative patients(P<0.05).There was no significant difference in the positive rate of fQRS between STEMI and NSTEMI patients(P>0.05).The LVEF of fQRS positive patients was lower than that of fQRS negative patients,and the left ventricular end-diastolic dimension(LVEDD)and left atrial diameter were higher than that of fQRS negative patients(P<0.05).Multiple linear analysis showed that fQRS and cTnⅠwere significantly positively correlated(P<0.05).Multivariate Cox regression analysis showed that fQRS was an independent predictor of MACE(P<0.05).Conclusion The fQRS was significantly associated with cTnⅠin ACS patients and fQRS was an independent predictor of MACE.

关 键 词：急性冠脉综合征 心电图 碎裂QRS复合波 肌钙蛋白Ⅰ 

分 类 号：R540.41[医药卫生—心血管疾病]