心电图P波离散度及QRS-T夹角预测STEMI患者急诊PCI术后MACE价值分析  

Prediction of P-wave Dispersion and QRS-T Angle on the Value of MACE of STEMI Patients After Emergency PCI

作　　者：徐燕爽 叶卉 罗艳华 Xu Yanshuang;Ye Hui;Luo Yanhua(Department of Functional Examination,Pingdingshan Hospital of Traditional Chinese Medicine,Pingdingshan,Henan,467000,China)

机构地区：[1]平顶山市中医医院功能检查科,河南平顶山467000

出　　处：《黑龙江医学》2024年第22期2709-2712,共4页Heilongjiang Medical Journal

摘　　要：目的:分析心电图P波离散度及QRS-T夹角对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)后发生主要不良心血管事件(MACE)的预测价值。方法:选取2019年8月—2022年10月平顶山市中医医院接受急诊PCI治疗的159例STEMI患者作为研究对象,根据PCI治疗后患者是否发生院内MACE分为非MACE组(n=130)和MACE组(n=29)。采用logistic回归分析STEMI患者经PCI治疗后发生MACE的影响因素,并绘制ROC曲线分析心电图P波离散度及QRS-T夹角对发生MACE的预测价值。结果:logistic回归分析结果显示,QRS-T夹角、P波离散度异常增大是影响STEMI患者PCI后发生MACE的独立危险因素(OR=1.073、1.078,P<0.05)。ROC曲线显示,QRS-T夹角及P波离散度预测STEMI患者PCI后发生MACE的AUC分别为0.830、0.834。二项指标联合检测的AUC为0.853,敏感度及特异度分别为75.86%、79.23%。结论:STEMI患者经PCI治疗后心电图P波离散度、QRS-T夹角增加与术后发生MACE密切相关,检测二者指标变化情况有利于评估STEMI患者PCI后是否发生MACE。Objective:To analyze the predictive value of P wave dispersion and QRS-T Angle on major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods:A total of 159 patients with STEMI who underwent emergency PCI in the hospital from August 2019 to October 2022 were selected.According to the occurrence of in-hospital MACE after PCI,the patients were divided into non-MACE group(n=130)and MACE group(n=29).Logistic regression model was used to analyze the influencing factors of MACE in STEMI patients after PCI,and ROC curve was drawn to analyze the predictive value of P wave dispersion and QRS-T Angle for MACE.Results:Logistic regression analysis showed that abnormal increase of QRS-T Angle and P-wave dispersion were independent risk factors for MACE after PCI in STEMI patients(OR=1.073,1.078;P<0.05).ROC showed that the AUC of QRS-T Angle and P-wave dispersion predicting MACE after PCI in STEMI patients was 0.830 and 0.834,respectively.AUC was 0.853,sensitivity and specificity were 75.86%and 79.23%,respectively.Conclusion:The increase of P wave dispersion and QRS-T Angle in ECG of STEMI patients after PCI is closely related to the occurrence of MACE after PCI,the detection of the changes of the two indicators is helpful to evaluate the occurrence of MACE after PCI in STEMI patients.

关 键 词：P波离散度 QRS-T夹角 急性ST段抬高型心肌梗死 急诊经皮冠状动脉介入术 

分 类 号：R542.22[医药卫生—心血管疾病]