摘要
目的探讨碎裂QRS(fQRS)波与急性心梗预后的相关性以及在评估急性心梗预后中的应用价值。方法随机入选120例急性心肌梗死(ST段抬高型)患者分为三组:A组(行急诊PCI或静脉溶栓治疗)、B组(择期PCI)、C组(非再灌注治疗),分别于发病后的4周、8周、12周,应用同步十二导联心电图观察fQRS波群,使用斑点追踪成像分析软件测量心室前壁径向收缩期应变率(RSR)及纵向收缩期应变率(LSR),随访三组患者入院后半年内心脏不良事件的发生情况。结果①A、B、C三组病例出现fQRS波的导联数均逐渐下降;其中C组病例fQRS波阳性导联数要明显高于A、B两组,A组最少(p<0.05);②A组患者LSR、RSR的改善程度要明显优于B组和C组,B组结果优于C组(p<0.05);③三组LVEF值均有提高(p<0.05),其中A组提高最为显著;三组患者的血NT-proBNP浓度均有所下降,A组的浓度下降最为明显,B组次之(p<0.05);④三组患者心脏不良事件的比较差异有统计学意义(p<0.05),A组发生比例明显高于C组,B组位于A、C二组之间。结论常规心电图中fQRS波的变化情况可以作为评估急性心肌梗死后患者心功能的恢复及预后的指标之一,为临床治疗提供较可靠的客观依据。
Objective Study of the correlation beween fQRS wave and the prognosis of acute myocardial infarction and which in the evaluation of prognosis of acute myocardial infarction. Methods Randomized 120 patients suffered AMI （St segment Elevation Myocardial Infarction） from January 2012 to August 2012 in our hospital, according to the patient＇s condition, take different treatment, divide into different groups： A （emergency PCI or thrombolytic recanalization）40 cases; B （electivePCl） 40 cases and C （non reperfusion therapy） 40 cases; all selected patients were given coronary vasodilatation, antiplatelet, anticoagulation, improving ventricular remodeling, promoting blood circulation to remove blood stasis, stable plaque and so on, observe fQRS wave by routine twelve lead ECG; measure LSR and RSR. Detect LVEF and NT proBNP, followed three group of patients cardiac adverse events happening within the six months. Results （three groups patients fQRS wave were gradually decreased over time （p〈0.05）; compare LSR and RSR, group A patients improved significantly better than group B and group C, Group B is better than that of group C （/9〈0.05）; （LVEF value of three groups has increased （p〈0.05）; three groups patients NT-proBNP were gradually decreased over time （p〈0.05）; Compare three groups of patients with cardiac adverse events, group A is significantly higher than group C, Group B in A, C between the two groups. Conclusions fQRS wave can be used as one of indexes in the recovery and prognosis of cardiac function in patients with acute myocardial infarction after the assessment, and provided a reliable objective basis for clinica hreatment
出处
《临床心电学杂志》
2013年第5期341-344,共4页
Journal of Clinical Electrocardiology
基金
内蒙古自然基金项目(项目号:NK-20100010)
关键词
急性心肌梗死
碎裂QRS波
斑点追踪
acute myocardial infarction
fragment QRS wave
speckle tracking imaging
