摘要
目的探讨心电图QRS时限对急性心肌梗死(AMI)患者的诊断及预后的预测价值。方法根据心电图QRS时限是否>100 ms将选取的159例AMI患者分为对照组(QRS时限<100 ms)81例和观察组(QRS≥100 ms)78例,对比两组患者的Killip心功能分级、N-末端脑钠肽前体(NT-pro BNP)水平、左室射血分数(LVEF)及主要心血管不良事件(MACE)发生情况。结果观察组血浆N-pro BNP水平[(2018.06±536.45)pg/m L]、肌酸激酶(CK)[(1523±94)U/L]、肌酸激酶同工酶(CK-MB)[(261±15)U/L]峰值均显著高于对照组[(1361.05±338.64)pg/m L,(861±53)U/L,(91±13)U/L],观察组左室射血分数(LVEF)[(41.93±4.19)%]显著低于对照组[(53.56±5.42)%](P<0.05)。观察组Killip心功能分级中Ⅰ级显著低于对照组,Ⅱ级及Ⅲ级均显著高于对照组(P<0.05)。两组Killip心功能分级中Ⅳ级比较,差异无统计学意义(P>0.05)。观察组MACE(包括恶性心律失常、急性肺水肿、心源性休克及心源性死亡发生率)总发生率显著高于对照组(P<0.05)。结论心电图QRS时限能够有效反应AMI患者心肌细胞电生理状况,与心肌细胞损伤有直接相关性,QRS时限越长,心功能越差,预后越差。
Objective To investigate prediction value of electrocardiographic QRS duration in diagnosis and prognosis of acute myocardial infarction（AMI） patients. Methods 159 patients with AMI were divided into control group（QRS time 100 ms, n=81） and observation group（QRS≥100 ms, n=78）. The Killip classes, level of N-terminal pro-brain natriuretic peptide（NT-pro BNP）, left ventricular ejection fraction（LVEF） and major adverse cardiovascular event（MACE） were compared. Results The levels of N-pro BNP [（2018.06±536.45） pg/m L], CK [（1523±94） U/L], CK-MB [（261±15） U/L] in observation group were significantly higher than control group; LVEF [（41.93±4.19） %] was higher in control group（P〈0.05）. ClassⅡand class Ⅲ of Killip in observation group were significantly higher than control group, while Class I was lower in observation group（P〈0.05）. There no difference between two groups with respect to class IV（P〉0.05）. The incidence of MACE in observation group was significantly higher（P〈0.05）. Conclusion The QRS duration can effectively reflect electrophysiological condition in myocardial cells of AMI patients, and is directly correlated to injury in myocardial cell. The longer QRS duration stays, the worse of heart function and prognosis will be.
出处
《中国循证心血管医学杂志》
2016年第9期1056-1058,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
QRS时限
急性心肌梗死
预后
QRS duration
Acute myocardial infarction（AMI）
Prognosis
