心电图U波倒置联合碎裂QRS波预测急性冠脉综合征患者PCI后预后的价值  

Predictive value of U-wave inversion combined with fragmented QRS on electrocardiogram for prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：李晓燕 汪洋 吴宝丽 姬劲锐 LI Xiaoyan;WANG Yang;WU Baoli;JI Jinrui(Department of Function,The Third People’s Hospital of Henan Province,Zhengzhou 450002,China)

机构地区：[1]河南省直第三人民医院功能科,河南郑州450002 [2]郑州人民医院心内科

出　　处：《精准医学杂志》2024年第1期78-80,87,共4页Journal of Precision Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ-20191068)。

摘　　要：目的探讨心电图U波倒置联合碎裂QRS波(fQRS)预测急性冠脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入术(PCI)后预后的价值。方法选取河南省直第三人民医院2017年10月-2019年9月收治的123例ACS患者,入院后均实施心电图检查,并接受PCI治疗,术后随访3个月,统计患者心电图U波倒置、fQRS发生及预后情况,探讨心电图U波倒置联合fQRS对ACS患者PCI后预后的预测价值。结果123例ACS患者心电图U波倒置发生率为39.84%,fQRS发生率为33.33%,预后不良的发生率为23.58%;预后不良组U波倒置、fQRS发生率均高于预后良好组(χ^(2)=20.547、26.080,P<0.05);心电图U波倒置联合fQRS预测ACS患者PCI后预后不良的特异度、准确度、曲线下面积(AUC)均高于心电图U波倒置、fQRS单独预测(χ^(2)=3.291~11.132,Z=3.543、4.861,P<0.05)。结论ACS患者PCI后预后不良的发生风险高,心电图U波倒置联合fQRS对ACS患者PCI后预后不良有较高的预测效能。Objective To investigate the value of U-wave inversion combined with fragmented QRS(fQRS)on electrocardiogram in predicting the prognosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 123 patients with ACS admitted to The Third People’s Hospital of Henan Province from October 2017 to September 2019 were included.All the patients underwent PCI after electrocardiogram examination,followed by 3 months follow-up.The percentages of U-wave inversion,fQRS,and a poor prognosis were analyzed to determine the predictive value of U-wave inversion combined with fQRS for post-PCI outcome in patients with ACS.Results Among the 123 patients with ACS,the percentages of U-wave inversion,fQRS,and a poor prognosis were 39.84%,33.33%,and 23.58%,respectively.The patients with a poor outcome showed significantly higher percentages of U-wave inversion and fQRS than those with a good outcome(χ^(2)=20.547,26.080,P<0.05).U-wave inversion plus fQRS showed significantly higher specificity,accuracy,and area under the curve in predicting a poor prognosis following PCI in patients with ACS,as compared with U-wave inversion and fQRS alone(χ^(2)=3.291-11.132,Z=3.543,4.861,P<0.05).Conclusion Patients with ACS have a high risk of a poor prognosis after PCI,which could be well predicted using U-wave inversion in combination with fQRS.

关 键 词：心电描记术 急性冠状动脉综合征 U波倒置 碎裂QRS波 经皮冠状动脉介入治疗 预后 

分 类 号：R542.2[医药卫生—心血管疾病] R540.41[医药卫生—内科学]