碎裂QRS波对AMI梗死相关血管的定位价值

Value of fragmented fQRS complex in the diagnosis of acute myocardial infarction related artery

目的探讨碎裂QRS波(fQRS)对急性心肌梗死(AMI)患者梗死相关血管的判断价值。方法回顾性分析147例经冠状动脉造影明确的急性心肌梗死患者,根据造影明确的导致本次事件的梗死相关血管进行分组,收集患者入院即刻及术后2天内12导联体表心电图,分析心电图上fQRS波分布导联与心肌梗死相关血管的相应关系。结果急性心肌梗死前降支、回旋支及右冠病变血管供血区对应的fQRS阳性率分别为33.3%、27.8%、76.2%,较病理性Q波显著增多。fQRS判断相应冠状动脉病变的敏感度分别为73.4%、61.5%、84.3%。结论体表心电图fQRS波的分布与梗死血管的位置密切相关,可作为心肌梗死病变血管的判断指标。

Objective To investigate the value of fragmented QRS complex in the diagnosis of acute myocardial infarction related artery. Methods One hundred forty-seven patients admitted with acute myocardial infarction by coronary angiography in this retrospective study. According to infarct related artery which lead to this event, the patients were divided into three groups： the left anterior descending group and the left circumflex group and the right coronary artery group. Standard 12-lead electrocardiogram records of patients were collected immediately and tow days of post-PCI. Then we analyzed the correlation of the leads with fQRS and the infarct related artery. Results The sensitivity of fragmented QRS complex correspond with left anterior descending territory and left circumflex territory and right coronary artery territory were 73.4% and 61.5% and 84.3%,higher than pathological Q wave.Also the sensitivity of fQRS to diagnose infarct related artery were 37.4% and 61.5% and 81.3%. Conclusions Presence of fragmented QRS complex of electrocardiogram was associated with infarct artery closely and it can be used as a parameter to diagnose criminal artery.