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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年02期

页码:

111-115

栏目:

临床医学

出版日期:

2014-03-20

文章信息/Info

Title:

Effect of fQRS on main adverse cardiac events in patients with acute myocardial infarction undergoing coronary intervention

文章编号:

1006-8147(2014)02-0111-05

作者:

段雯婷; 马向红; 李广平

(天津医科大学第二医院心脏科,天津 300211)

Author(s):

DUAN Wen-ting;  MA Xiang-hong;  LI Guang-ping

(Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)

关键词:

QRS碎裂波; 急性心肌梗死; 冠脉介入治疗; 预测

Keywords:

fragmented QRS; acute myocardial infarction; coronary intervention; forecasting

分类号:

R542.2+2

DOI:

-

文献标志码:

A

摘要:

目的：分析fQRS与冠脉狭窄程度及主要不良心血管事件（MACE）的相关性，探讨其预测价值。方法：试验共纳入因急性心肌梗死（AMI）接受经皮冠状动脉介入治疗（PCI）术治疗的患者261例（其中心电图存在fQRS患者147例，无fQRS患者114例）。分析比较患者的一般临床资料、Gensini评分，随访（14.2±0.8）月内MACE的情况。 结果：（1）与nfQRS组相比，心电图存在fQRS的患者肌钙蛋白、肌酐、尿酸水平及Gensini评分较高，射血分数较低（P <0.05）。（2）Kapla-Meier生存分析提示fQRS组免于MACE的概率低于nfQRS组，log-rank检验P <0.001。两组免于心源性死亡的生存率无显著性差异，log-rank检验P =0.115。（3）多因素Cox回归分析显示糖尿病史、左室射血分数、心梗48 h内心电图是否存在fQRS是预测MACE的独立危险因素。 结论:心梗48 h内出现fQRS是接受PCI治疗的AMI患者不良心血管事件的独立预测因子。

Abstract:

Objective: To investigate effect of fQRS on the degree of coronary stenosis and main adverse cardiac events(MACE) in patients with acute myocardial infarction(AMI) who underwent percutaneous coronary intervention(PCI)．Methods: The study included 261 consecutive patients with AMI who underwent PCI .Who were divided into two groups：ECG with fQRS(n =147) and without fQRS(n =114)．Baseline clinical characteristics，Gensini score and the incidence of MACE up to（14.2±0.8）month after AMI were compared between the two groups．Results: (1)Patients with fQRS of ECG had higher cTnI levels and Gensini score，lower left ventricular ejection fraction (LVEF)in comparison with patients with non-fragmented QRS（P ＜0.05）．(2)A Kaplan-Meier analysis showed a significantly lower MACE events-free rate in patients with fQRS than those without fQRS（Log-rank test: P <0.001）．The cardiac mortality rates were of no difference between two groups（Log-rank test: P =0.115）. (3)A multivariate Cox proportional hazards regression analysis indicated that diabetes mellitus disease ,LVEF and the presence of a fQRS at the 48^th hour were independent predictors of MACE.　Conclusion: The presence of a fQRS at 48 h is an independent predictor of MACE in patients with AMI undergoing PCI．

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备注/Memo

备注/Memo:

作者简介 段雯婷（1988-），女，硕士在读，研究方向：心血管内科；

通信作者：马向红：E-mail: maxianghong@eyou.com.cn。

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更新日期/Last Update: 2014-03-31