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|本期目录/Table of Contents|

碎裂QRS波对ST段抬高型急性心肌梗死1年期预后的预测价值

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第3期
页码:
294-297
栏目:
临床研究
出版日期:
2015-01-11

文章信息/Info

Title:
Predictive value of fragmented QRS wave for 1-year prognosis of patients with ST segment elevation acute myocardial infarction
作者:
李冰晓; 陈 欣; 胡伟国; 黄高忠
（上海交通大学附属第六人民医院心内科，上海 200233）
Author(s):
LI Bing-xiao;  CHEN Xin;  HU Wei-guo;  HUANG Gao-zhong
(Department of Cardiology, Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China)
关键词:
碎裂QRS波; 心肌梗死; 急性; 心血管事件
Keywords:
fragmented QRS;  acute anterior myocardial infarction;  cardiovascular events
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:探讨静息12导联心电图的碎裂QRS波(fQRS)对于ST段抬高型急性心肌梗死（STEMI）患者1年期预后的预测价值。方法:选择STEMI患者154例，分为无fQRS、fQRS两组，随访观察1年。分别比较了各组的基本资料、危险因素及造影情况、左室射血分数(LVEF)、室壁运动异常发生率，恶性心律失常发生率和全因病死率。结果:①两组患者基本资料及3种主要心血管危险因素未见显著差异，fQRS组较无fQRS组肌钙蛋白I（TnI）值高，3支病变比例大；②fQRS组患者较无fQRS组患者住院期间病死率高、LVEF<50%比例高；③fQRS组1年期随访病死率、恶性心律失常发生率、LVEF%<50%比例均显著高于无fQRS组，LVEF%值较低。④同组患者住院期间与1年随访比较，无fQRS组病死率和LVEF<50%比例未见显著差异；室速发生率和室壁运动异常发生率有所减少，LVEF改善。fQRS组病死率增加，其他观察指标均未见明显统计学差异。结论:12导联心电图fQRS对于STEMI患者的预后具有一定预测价值。
Abstract:
AIM:To investigate the predictive value of fragmented QRS wave in the resting 12-lead ECG for 1-year prognosis of patients with ST segment elevation acute myocardial infarction (STEMI). METHODS: One hundred and fifty-four patients with acute STEMI were divided into non-fQRS group and fQRS group and all patients were followed up for 1 year. Baseline data, risk factors, coronary angiography, left ventricular ejection fraction (LVEF), incidences of ventricular wall motion abnormality and malignant arrhythmia, and all-cause mortality were compared among groups. RESULTS: No significant difference was observed among groups in baseline data and three major cardiovascular risk factors. The cTnI value in fQRS group was higher than in non-fQRS group. In fQRS group, the proportion of double vessel lesion was smaller, whereas the three-vessel lesion proportion was greater. During the period of hospitalization, fQRS group had higher mortality and higher proportion of low LVEF (<50%) than non-fQRS group. During a 1-year follow-up, fQRS group had higher mortality, more malignant arrhythmia and larger proportion of low LVEF (<50%) than non-fQRS group. No significant difference was found in mortality rate and low LVEF (<50%) proportion between the 1-year follow-up and the period of hospitalization in non-fQRS group, whereas the incidences of ventricular tachycardia and ventricular wall motion abnormality were significantly decreased. In fQRS group, mortality rate was higher during 1-year follow-up. No significant difference was seen in other indexes in fQRS group. CONCLUSION: fQRS is of some predictive value for the 1-year prognosis of patients with STEMI.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2014-06-24.
通讯作者：胡伟国，副主任技师，主要从事心电学研究Email：hwg_sj@126.com
作者简介：李冰晓，住院医师Email：13801765911@126.com
更新日期/Last Update: 2015-02-03