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碎裂QRS波对急性非ST段抬高型心肌梗死患者预后的影响 被引量:15
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作者 杨曙艳 齐大屯 +6 位作者 李牧蔚 刘伟利 王宪沛 张优 严干新 胡大一 高传玉 《中华实用诊断与治疗杂志》 2017年第5期479-481,共3页
目的探讨急性非ST段抬高型心肌梗死(non-ST elevated acute myocardial infarction,NSTEMI)患者碎裂QRS波对临床预后的影响。方法经冠状动脉造影确诊NSTEMI患者312例,根据住院期间第一份心电图是否存在碎裂QRS波分为碎裂QRS波组173例和... 目的探讨急性非ST段抬高型心肌梗死(non-ST elevated acute myocardial infarction,NSTEMI)患者碎裂QRS波对临床预后的影响。方法经冠状动脉造影确诊NSTEMI患者312例,根据住院期间第一份心电图是否存在碎裂QRS波分为碎裂QRS波组173例和无碎裂QRS波组139例,比较2组一般资料,随访6个月并记录2组主要不良心脏事件(major adverse cardiac events,MACE)发生情况。结果碎裂QRS波组3支以上冠状动脉狭窄≥50%者比率(51.45%)、既往心肌梗死比率(52.51%)高于无碎裂QRS波组(36.69%、30.22%),左室射血分数[(54.00±5.60)%]低于无碎裂QRS波组[(61.00±5.80)%],高敏C反应蛋白水平[8.1(3.2,19.2)mg/L]高于无碎裂QRS波组[6.1(3.2,12.6)mg/L](P<0.05);碎裂QRS波组总MACE发生率(33.53%),再次经皮冠状动脉介入治疗(8.67%)、复发性心绞痛比率(18.45%)均高于对照组(15.83%、2.88%、7.19%)(P<0.05)。结论碎裂QRS波是NSTEMI患者预后不良的重要心电图特征。 展开更多
关键词 急性非st段抬高型心肌梗死 心电图 碎裂QRS波 主要不良心脏事件
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Short-term Prognosis of Fragmented QRS Complex in Patients with Non-ST Elevated Acute Myocardial Infarction 被引量:14
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作者 Min Li Xiao Wang +4 位作者 Shu-Hua Mi Zhe Chi Qing Chen Xin Zhao Shao-Ping Nie 《Chinese Medical Journal》 SCIE CAS CSCD 2016年第5期518-522,共5页
Background:There remains significant debate as to the relationship between fragmented QRS (fQRS) complexes on electrocardiogram (ECG) and acute myocardial infarction (AMI).Few studies have reported on this rela... Background:There remains significant debate as to the relationship between fragmented QRS (fQRS) complexes on electrocardiogram (ECG) and acute myocardial infarction (AMI).Few studies have reported on this relationship in non-ST elevated AMI (NSTEMI),and thus,we attempt to assess this relationship and its potential short-term prognostic value.Methods:This was a single-center,observational,retrospective cohort study.A total of 513 consecutive patients (399 men,114 women) with NSTEMI within 24 h who underwent coronary angiography at our department,between January 1,2014,and December 31,2014.Patients were divided into 2 groups according to the presence or absence of fQRS complex on the admission ECG.fQRS complexes were defined as the existence of an additional R' or crochetage wave,notching in the nadir of the S wave,RS fragmentation,or QS complexes on 2 contiguous leads.All patients were followed up for 6 months,and all major adverse cardiac events (MACE) were recorded.Results:In this study,there were 285 patients with fQRS ECG in the 513 patients with NSTEMI.The number of patients with 0-2 coronary arteries narrowed by ≥50% in fQRS group were less while patients with 3 narrowed arteries were more than in the non-fQRS group (P =0.042).There were fewer Killip Class Ⅰ patients in the fQRS group (P =0.019),while Killip Class Ⅱ,Ⅲ,and Ⅳ patients were more in the fQRS group than in the non-fQRS group (P =0.019).Left ventricular ejection fraction levels were significantly lower in the fQRS group (P =0.021).Baseline total cholesterol,low-density lipoprotein,creatinine,creatine kinase,homocysteine,high-sensitivity C-reactive protein (CRP),and red blood cells distribution width levels were significantly higher in the fQRS group.Total MACE (MACE,P =0.028),revascularization (P =0.005),and recurrent angina (P =0.005) were also significantly greater in the fQRS group.On final logistic regression analysis,after adjusting for baseline variables,the following 展开更多
关键词 Fragmented QRS Complexes Major Adverse Cardiac Events non-st elevated acute myocardial infarction
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