摘要
目的探讨碎裂QRS波(fQRS)对急性ST段抬高心肌梗死(STEMI)直接PCI术后12个月内患者再发主要不良心脏事件(MACE)的预测意义。方法入选接受直接PCI的急性STEMI患者92例,记录12导联心电图,按PCI后72 h内是否出现碎裂QRS波,分为fQRS组和非fQRS组。随访12个月,比较两组患者MACE的发生率。结果 fQRS组患者在术后1年MACE显著高于非fQRS组[15(31.2%)vs.4(9.1%)]。生存分析显示,fQRS组患者无事件生存率明显减低(P<0.004);Cox风险分析显示,fQRS是急性STEMI患者PCI术后再发MACE的独立预后危险因素(HR 2.19,95%CI 1.38-3.50,P=0.023)。结论 fQRS波可能是判别急性STEMI患者直接PCI术后再发MACE的一种独立预测指标。
Objective To study the prognostic value of fragmented QRS （fQRS） in the recurrence of cardiac events in acute STEMI patients underwent emergency percutaneous coronary intervention （PCI）. Methods Ninety-two acute STEMI patients who underwent emergency PCI were enrolled. The presence of fQRS was evaluated by a 12-lead ECG in 72 h after PCI. Cardiac events （myocardial infarction, need for revascularization or cardiac death） and all-cause mortality were recorded in all patients during 12 months follow-up. Results Cardiac event rate[15 （31.3%） vs. 4 （9.1%）]were higher in the fQRS group （n=48） compared with the non-fQRS group （n=44） during a mean follow-up of 12 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events in the fQRS group （P 〈 0.004）. The results of Cox regression model analysis revealed that signiifcant fQRS was an independent signiifcant predictor for cardiac events （HR 2.19, 95%CI 1.38-3.50, P=0.023）. Conclusions The presence fQRS is an independent risk factor for poor prognosis in STEMI patients undergoing emergency PCI.
出处
《中国介入心脏病学杂志》
2014年第5期313-317,共5页
Chinese Journal of Interventional Cardiology
