碎裂QRS波与冠心病心肌缺血及NT-proBNP的相关性研究

Relationship between fragmented QRS wave and myocardial ischemia in coronary heart disease and NT-proBNP

目的:探讨碎裂QRS波(fQRS)与冠心病(CHD)心肌缺血及N末端脑钠肽前体(NT-proBNP)之间的关系。方法:回顾性分析包头市中心医院2012-01-2013-12在心内科住院的临床上考虑冠心病并进行过选择性冠状动脉造影(CAG)检查的患者492例,根据患者入院后前3d内心电图(ECG)中有无fQRS波将其分为两组,其中A组(fQRS波阳性组)271例,B组(fQRS波阴性组)221例,比较两组患者冠状动脉狭窄及NT-proBNP水平的差异。同时将A组分为肢体导联组、胸导联组和肢体导联+胸导联组3个亚组,比较各个亚组之间NT-proBNP水平的差异。结果:A组CHD心肌缺血发病率与NT-proBNP水平均高于B组(均P<0.05);肢体导联、胸导联和肢体导联+胸导联3个亚组间NT-proBNP水平依次上升。结论:fQRS波对心功能不全的诊断以及预后的评估有一定的价值,fQRS波对CHD心肌缺血有一定的预测价值。

Objective：To investigate the relationship between fragmented QRS（fQRS）wave and myocardial ischemia in coronary heart disease.Method：A total of 492 patients with clinically suspected coronary heart disease（CHD）and underwent selective coronary angiography（CAG）from Baotou Central Hospital during January 2012 to December 2013 were selected.According to the standard 12 leads electrocardiogram（ECG）performed in first three days after admission,the subjects were divided into two groups according to with（group A,n=271）or without fQRS（group B,n=221）.The extent of coronary stenosis and the difference in NT-proBNP level between two groups were compared.The A group was divided into three subgroups：limb lead,chest lead,and limb lead plus chest lead group.The difference of NT-proBNP level between the three subgroups were compared.Result：The incidence of myocardial ischemia of CHD and the level of NT-proBNP in group A were significantly higher than those in group B（both P〈0.05）;The level of NT-proBNP in three subgroups increased gradually.Conclusion：Fragmented QRS wave has a certain value in the diagnosis and prognosis of cardiac insufficiency,and has certain value to predict myocardial ischemia of CHD.