摘要
目的 探讨碎裂QRS波(fQRS)与急性心肌梗死(AMI)远期预后的关系。方法 据体表心电图是否出现fQRS波将755例患者分为fQRS组和非fQRS组,随访5年,观察心脏不良事件发生率及全因死亡率(再发心绞痛、再发心梗、心功能不全、再次住院、心源性死亡、全因死亡)。对行PCI的患者,分析fQRS与冠脉病变的关系。多元Logistic回归分析fQRS波、左心室舒张末期内径(LVEDD)、左室射血分数(EF)以及左室短轴缩短率(FS)与心血管事件间的关系。结果 fQRS波组心血管事件发生率均显著高于非fQRS波组(P<0.001)。fQRS波组LVEDD大于非fQRS组,EF及左室短轴缩短率FS小于非fQRS波组,(P<0.05)。二组冠脉病变差异无统计学意义(P>0.05)。多元logistic回归显示fQRS是再发心绞痛的独立危险因素,OR=2.70;是再发心梗的独立危险因素,OR=3.00;是心功能不全的独立危险因素,OR=2.49,FS是心功能不全的保护性因素,OR=0.90;fQRS是再次住院的独立危险因素,OR=2.53;FS是再次住院的保护性因素,OR=0.91;fQRS是心源性死亡的独立危险因素,OR=3.75。结论 心梗急性期fQRS波的出现与患者5年内心血管事件明显相关。
Objective To investigate the relationship between fragmented QRS and long-term prognosis in patients with acute myocardial infarction(AMI).Methods Analyzed the electrocardiograms about seven hundred and fifty-five cases, and these patients were divided into two groups according to the presence of fQRS wave.Cardiac events(Recurrence of angina pectoris;Recurrence of Myocardial infarction;cardiac insufficiency;Hospitalization for cardiovascular events again;cardiac death;all-cause mortality) were studied in all patients during 5 years follow-up.Analysis of the relationship between the occurrence of fQRS and cardiovascular events within 5 years.Analysis of the relationship between the occurrence of fQRS and cardiovascular events in percutaneous coronary intervention(PCI) and non-PCI group. The relationship between fQRS with coronary artery lesions were assessed for patients who suffer PCI treatment. The relation between fQRS and Cardiac events were analyzed by Logistic regression analysis.Results The incidence of cardiac events in fQRS group was significantly higher than that in non-fQRS group(P<0.001).The left ventricular end-diastolic diameter(LVEDD) in the fQRS group was larger than that in the non-fQRS group, and the left ventricular ejection fraction(EF) and left fractional shortening(FS) were smaller than those in the non-fQRS group(P<0.05).There was no statistical difference in the degree of coronary artery disease between the two groups(P>0.05).QRS was an independent risk factor for recurrent angina pectoris, OR=2.70;fQRS was an independent risk factor for recurrent myocardial infarction(OR=3.0);fQRS was an independent risk factor for cardiacdysfunction(OR=2.49),FS was a protective factor for cardiac dysfunction(OR=0.90);fQRS was an independent risk factor for re-hospitalization, OR=2.53;FS was an Protective factors for readmission, OR=0.91;fQRS was an independent risk factor for cardiogenic death, OR=3.75.Conclusion fQRS plays an important role in predicting cardiovascular events within 5 years after AMI.
作者
谭文云
张宁
汝磊生
王冬梅
孔令峰
王刚
TAN Wenyun;ZHANG Ning;RU Leisheng;WANG Dongmei;KONG Lingfeng;WANG Gang(Department of Ultrasound,The First Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《中国煤炭工业医学杂志》
2022年第4期385-391,共7页
Chinese Journal of Coal Industry Medicine
基金
河北省卫生健康委员会重点科技研究计划(编号:20191210)。
关键词
急性心肌梗死
碎裂QRS波
经皮冠状动脉介入治疗
预后
Acute myocardial infarction
Fragmented QRS complex
Percutaneous coronary intervention treatment
Prognosis
