心电图T/QRS比值的变化对高危非ST段抬高型心肌梗死的预测价值  

The predictive value of changes in T/QRS ratio for high-risk non-ST-elevation myocardial infarction

作　　者：孙向华 杨菲[2] 李永利 Sun Xianghua;Yang Fei;Li Yongli(Department of Cardiology,Baoji High-tech Hospital,Baoji 721013,Shaanxi Province,China;Department of Function,Baoji People's Hospital,Baoji 721000,Shaanxi Province,China)

机构地区：[1]宝鸡高新医院心血管内科,宝鸡721013 [2]宝鸡市人民医院功能科,宝鸡721000

出　　处：《中国基层医药》2025年第2期190-196,共7页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨心电图T/QRS比值的变化(△T/QRS)在预测高危非ST段抬高型心肌梗死(non-ST elevation myocardial infraction,NSTEMI)危险分层中的应用价值。方法选择2022年2月至2024年2月在宝鸡高新医院心血管内科收治的NSTEMI患者158例为研究对象,依据全球急性冠状动脉事件注册(global registry of acute coronary events,GRACE)评分将纳入的NSTEMI患者分成低、中、高危组;收集所有患者基线资料及临床检查结果,并比较分析不同危险分层NSTEMI患者的临床结果;通过Spearman相关性分析△T/QRS与NSTEMI患者GRACE评分的相关性;logistic回归分析影响NSTEMI患者病情严重程度的危险因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估△T/QRS对高危NSTEMI患者的预测价值。结果低危组、中危组和高危组NSTEMI患者心电图下壁导联△T/QRS及侧壁导联△T/QRS值依次增加[(1.01±0.25)比(1.32±0.19)比(1.74±0.21),F=6.10,P<0.001;(1.01±0.13)比(1.36±0.11)比(1.66±0.05),F=5.73,P<0.001];通过Spearman相关性分析显示,NSTEMI患者下壁导联△T/QRS及侧壁导联△T/QRS与GRACE评分之间存在正相关(r=0.73,P<0.001;r=0.78,P<0.001);logistic回归分析显示,下壁导联△T/QRS及侧壁导联△T/QRS值增高是高危NSTEMI患者的危险因素,OR值分别为10.361及10.738。ROC曲线分析结果提示下壁导联△T/QRS及侧壁导联△T/QRS预测高危NSTEMI患者的曲线下面积分别为0.932和0.855。结论下壁导联T/QRS和侧壁导联T/QRS比值改变与NSTEMI患者危险分层有关,可以较好地预测高危NSTEMI患者,具有良好的临床应用前景。Objective:To investigate the application value of changes in T/QRS ratio(△T/QRS)in predicting risk stratification for high-risk non-ST-elevation myocardial infarction(NSTEMI).Methods:A total of 158 patients with NSTEMI who received treatment at the Department of Cardiology,Baoji High-tech Hospital,from February 2022 to February 2024 were included in this study.Based on the global registry of acute coronary events score,the enrolled patients with NSTEMI were divided into low-,medium-,and high-risk groups.Baseline data and clinical examination results were collected for all patients,and the clinical outcomes of patients with NSTEMI in different risk stratification groups were compared and analyzed.Spearman correlation analysis was performed to assess the correlation between△T/QRS and the global registry of acute coronary events score in patients with NSTEMI.Logistic regression analysis was conducted to identify risk factors that influence the severity of NSTEMI.The predictive value of△T/QRS for high-risk NSTEMI in patients was evaluated using the receiver operating characteristic curve.Results:In patients with NSTEMI from the low-risk,medium-risk,and high-risk groups,the values of△T/QRS in the inferior and lateral leads increased sequentially[(1.01±0.25)vs.(1.32±0.19)vs.(1.74±0.21),F=6.10,P<0.001;(1.01±0.13)vs.(1.36±0.11)vs.(1.66±0.05),F=5.73,P<0.001].Spearman correlation analysis demonstrated a positive correlation between△T/QRS in the inferior and lateral leads and the global registry of acute coronary events score in patients with NSTEMI(r=0.73,P<0.001;r=0.78,P<0.001).Logistic regression analysis revealed that elevated△T/QRS values in the inferior and lateral leads were risk factors for high-risk NSTEMI,with odds ratios of 10.361 and 10.738,respectively.Receiver operating characteristic curve analysis indicated that the area under the curve for predicting high-risk NSTEMI patients using△T/QRS in the inferior and lateral leads was 0.932 and 0.855,respectively.Conclusions:△T/QRS in the inferi

关 键 词：急性冠状动脉综合征 非ST段抬高型心肌梗死 心电描记术 危险因素 回归分析 ROC曲线 

分 类 号：R542.22[医药卫生—心血管疾病]