破裂QRS波群对冠心病患者生存状况的影响

Effect of fQRS Wave Group on Survival Status of Patients with Coronary Heart Disease

【目的】探讨碎裂QRS(fQRS)波群对冠心病(CHD)患者生存状况的影响。【方法】回顾性分析2014年6月至2017年6月本院收治的1 043例CHD患者的临床资料;依据患者入院十二导联同步心电图是否出现fQRS将其分为非fQRS组(n=205)和fQRS组(n=838)。比较两组患者心脏超声结果、心电特征和预后情况。【结果】fQRS组患者左室射血分数(LVEF)低于非fQRS组患者;室间隔厚度、左室舒张末内径(LVDD)、三支病变发生率高于非fQRS组患者;差异均具有统计学意义(均P<0.05);两组左室收缩末内径(LVSD)、左室舒张末容积(LVDV)、左室收缩末容积(LVSV)比较;差异无统计学意义(P>0.05)。fQRS组患者的电轴低于非fQRS组患者;QRS时限、P波时限、ST段改变率高于非fQRS组患者;差异均具有统计学意义(P<0.05)。fQRS组患者的心绞痛、心律失常、心源性死亡、死亡发生率高于非fQRS组患者;生存时间短于非fQRS组患者;差异具有统计学意义(P<0.05)。【结论】CHD合并异常Q波患者心功能不良;心血管事件发生率、心源性死亡率和死亡率较高;心电图出现fQRS波对患者预后有较好的预测价值。

【Objective】 To investigate the effect of fragmentation QRS (fQRS) wave group on survival of patients with coronary heart disease (CHD).【Methods】 The clinical data of 1043 patients with CHD admitted from June 2014 to June 2017 were analyzed retrospectively. According to the presence of fQRS in the 12-lead synchronous electrocardiogram, the patients were divided into two groups: non fQRS group (n=205) and fQRS group (n=838). The results of echocardiography, electrocardiogram and prognosis were compared between the two groups. 【Results】 The incidence of left ventricular ejection fraction (LVEF) in the fQRS group was significantly higher than that in the non-fQRS group (P<0.05). The incidence of left ventricular septal thickness, left ventricular end-diastolic diameter (LVDD) and the incidence of three-vessel disease was significantly higher in the fQRS group than in the non fQRS group (P<0.05). Left ventricular end-systolic diameter (LVSD), left ventricular end-diastolic volume (LVDV), left ventricular end-systolic volume (LVSV) were not significantly different between the two groups (P>0.05). The electric axis of the fQRS group was lower than that of the non-fQRS group. The QRS duration, P wave duration and ST segment change rate were significantly higher in the fQRS group than in the non-fQRS group (P<0.05). The incidence of angina pectoris, arrhythmia, cardiac death and death in the fQRS group was higher than that in the non-fQRS group, and the survival time was shorter than that in the fQRS group (P<0.05).【Conclusion】 The incidence of cardiac dysfunction, cardiovascular events, cardiogenic mortality and death are higher in patients with CHD complicated with abnormal Q wave. When fQRS wave appears in electrocardiogram, it has good prognostic value.