冠状动脉完全闭塞病变患者碎裂QRS波与PCI术后心功能改善的关系

Changes of cardiac function after percutaneous coronary intervention and relationship between them and fragmented QRS complex in patients with coronary total occlusion

目的观察冠状动脉完全闭塞病变患者接受经皮冠状动脉介入治疗(PCI)术后心功能的改善情况与合并QRS波碎裂的关系。方法纳入2006年6月～2011年10月完全闭塞病变患者126例,根据入院时心电图的QRS波形态分为碎裂QRS波组(fQRS组,n=48)和无碎裂QRS波组(nfQRS组,n=78),分析两组患者PCI术后6个月的心功能改善情况有无差异。结果两组患者经PCI治疗后左室射血分数(LVEF)增加,左室舒张末容积指数(LVEDVI)减少,同时6分钟步行试验距离也较前明显增加,但与nfQRS波组相比,fQRS波组患者LVEF[(54.04士3.11)%vs.(50.09±4.06)%,P<0.05]增加更明显,LVEDVI[(76.58士6.19)ml/m2vs.(79.00±8.19)ml/m2,P<0.05]减少更明显,同时6分钟步行试验显示步行距离更长[(449.42±100.99)mvs.(439.60士84.46)m,P<0.05]。结论介入治疗能够改善冠状动脉完全闭塞患者心功能,而且合并fQRS波的患者较不合并fQRS波的患者改善更加明显。

Objective To observe the changes of cardiac function after percutaneous coronary intervention （ PCI ） and relationship between them and fragmented QRS （ fQRS ） complex in the patients with coronary total occlusion （ CTO ） . Methods The patients （ n=126 ） with CTO were chosen from Jun. 2006 to Oct. 2011 and divided into fQRS （ n=48 ） and non-fQRS group （ n=78 ） according to the QRS complex types in ECG. The difference in the changes of cardiac function was analyzed between two groups after PCI for 6 months. Results After PCI in two groups, left ventricular ejection fraction （ LVEF ） increased, left ventricular end-diastolic volume index （ LVEDVI ） decreased, and the distance of 6-minute walk test （ 6MWT ） increased significantly. Compared with non-fQRS group, fQRS group had more significant increase of LVEF [ （ 50.09 ± 4.06 ） % vs. （54.04±3.11 ） %, P〈0.05], more significant decrease of LVEDVI [ （79.00±8.19 ） mL/m2 vs. （76.58± 6.19 ） mL/m^2, P〈0.05] and longer distance of 6MWT [ （ 439.60± 84.46 ） m vs. （ 449.42 ± 100.99 ） m, P 〈0.05]. Conclusion PCi can improve the cardiac function in the patients with CTO, which is more significant in the patients with fQRS than in those without fQRS.