碎裂QRS波对急性心肌梗死患者预后的影响

Influence of the prognosis of fragmented QRS wave on patients with acute myocardial infarction

目的探讨碎裂QRS波(f QRS)对急性心肌梗死(AMI)患者预后的影响。方法随机选择确诊为AMI的住院患者562例,观察12导联心电图QRS波形态,具有f QRS的患者作为观察组,其余作为对照组。分析两组患者的临床特点、存活出院率,1 a内心血管事件的发生情况以及1年存活率。结果观察组269例,对照组293例。观察组与对照组相比,心功能Killip分级Ⅲ级(16.73%与10.24%)、Ⅳ级(11.90%与6.83%)、新发生的恶性心律失常(15.96%与9.56%)、1 a心性事件发生率(45.02%与29.61%)高,存活出院率(85.13%与90.78%)以及1年存活率(75.00%与85.56%)低,差异有统计学意义(P<0.05)。结论伴有f QRS波的AMI患者心功能差,更易发生恶性心律失常,预后差。f QRS是预测AMI患者预后的独立危险因素。

Objective To study the influence of the prognosis of fragmented QRS wave( f QRS) on patients with acute myocardial infarction( AMI). Methods 562 cases of hospitalized patients with the diagnosis of AMI were randomly selected and12-lead electrocardiogram QRS wave form was observed,with f QRS patients as observation group,the rest as control group. The clinical characteristics,hospital survival rates,1 year incidence of cardiac events and survival rates of two groups were analyzed.Results There were 269 cases in the observation group,and 293 cases in the control group. Compared with the control group,the heart function Killip classⅢ( 16. 73% and 10. 24%),Ⅳ( 11. 90% and 6. 83%),the new occurrence of malignant arrhythmia( 15. 96% and 9. 56%),1 year incidence of cardiac events( 45. 02% and 29. 61%) were higher,hospital survival rates( 85. 13% and 90. 78%) and 1 year survival rates( 75. 00% and 85. 56%) were lower in the observation group,the differences were statistically significant( P<0. 05). Conclusion The cardiac function of AMI patients with f QRS is worse,which are more likely to undergo malignant arrhythmia,and the prognosis is worse. f QRS is an independent risk factor to predict the prognosis of patients with AMI.