心电图fQRS联合高峰射血率、高峰充盈率对NSTEMI患者短期MACE的预测价值  

Predictive value of fQRS on electrocardiogram combined with peak ejection rate and peak filling rate for short-term MACE in patients with NSTEMI

作　　者：黄雅丽 孙腾飞 HUANG Yali;SUN Tengfei(Electrocardiogram Room,Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院心电图室,325000

出　　处：《心电与循环》2024年第4期381-385,共5页Journal of Electrocardiology and Circulation

摘　　要：目的 探讨心电图碎裂QRS波群(f QRS)联合高峰射血率(PER)、高峰充盈率(PFR)对急性非ST段抬高心肌梗死(NSTEMI)患者短期主要不良心血管事件(MACE)的预测价值。方法 回顾性选取2020年1月至2022年3月浙江中医药大学附属温州市中医院收治的120例NSTEMI患者为研究对象,记录患者出院后6个月MACE发生情况,比较有、无发生MACE的NSTEMI患者临床资料,采用多因素logistic回归分析NSTEMI患者短期发生MACE的影响因素,采用ROC曲线分析这些影响因素单独或联合预测NSTEMI患者短期发生MACE的效能。结果 随访6个月期间发生MACE 23例,未发生MACE 97例。MACE组患者心率、舒张压、收缩压、PER以及吸烟、饮酒、心肌梗死史、冠状动脉疾病史、经皮冠状动脉介入治疗史、冠状动脉旁路移植手术史、心电图f QRS比例均高于非MACE组,而年龄、血红蛋白、淋巴细胞计数、天冬氨酸转氨酶、PFR均低于非MACE组,差异均有统计学意义(均P<0.05)。心电图f QRS、PER、PFR均是NSTEMI患者短期发生MACE的独立影响因素(OR=2.678、2.361、2.450,均P<0.05)。心电图f QRS、PER、PFR单独及3项联合预测NSTEMI患者短期发生MACE的AUC分别为0.654、0.698、0.807、0.931。结论 心电图f QRS联合PER、PFR对NSTEMI患者短期发生MACE具有较高的预测价值。Objective To investigate the predictive value of fragmented QRS(fQRS)on electrocardiogram combined with peak ejection rate(PER)and peak filling rate(PFR)for short-term major adverse cardiovascular event(MACE)in patients with acute non ST segment elevation myocardial infarction(NSTEMI).Methods A retrospective study was conducted on 120 patients with NSTEMI treated at the Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from January 2020 to March 2022.The incidence of MACE within 6 months after discharge was recorded.Clinical data of patients with and without MACE were compared.Multivariate logistic regression analysis was performed to identify factors influencing the occurrence of short-term MACE.The efficacy of these factors for predicting short-term MACE in patients with NSTEMI alone and separately was analyzed using ROC curve.Results During the 6 months of follow-up,there were MACE in 23 cases and no MACE in 97 cases.Heart rate,diastolic blood pressure,systolic blood pressure,PER,and the proportions of patients with smoking history,drinking history,history of myocardial infarction,history of coronary artery disease,history of percutaneous coronary intervention,history of coronary artery bypass grafting and electrocardiographic fQRS in the MACE group were higher than those in the non-MACE group. Age, hemoglobin, lymphocyte count, aspartate aminotransferase and PFR were lower than those in the non-MACE group. The differences were statistically significant (all P<0.05). Electrocardiographic fQRS, PER and PFR were independent influencing factors of short-term MACE in patients with NSTEMI (OR=2.678, 2.361, 2.450, all P< 0.05). The AUCs of fQRS, PER, PFR, and their combination for predicting short-term MACE in patients with NSTEMI were 0.654, 0.698, 0.807 and 0.931, respectively. Conclusion The combination of fQRS with PER and PFR has high predictive value for the occurrence of short-term MACE in patients with NSTEMI.

关 键 词：急性非ST段抬高心肌梗死 主要不良心血管事件 碎裂QRS波群 高峰射血率 高峰充盈率 

分 类 号：R542.22[医药卫生—心血管疾病]