碎裂QRS波对急性非ST段抬高型心肌梗死患者预后的预测价值

Predictive value of fragmented QRS wave for prognosis in patients with acute no ST elevation myocardial infarction

目的:探讨碎裂QRS波(fQRS)对急性非ST段抬高型心肌梗死(NSTEMI)患者预后的预测价值。方法:根据心电图测定结果,2015年1月~2017年2月我院收治的NSTEMI患者120例被分为fQRS组(73例)和无fQRS组(47例)。两组治疗方法相同。比较两组一般资料及随访1年内主要心血管不良事件(MACE)发生率。结果:两组心率、血脂异常率、高血压率及糖尿病率无显著差异(P均>0.05)。与无fQRS组比较,fQRS组左室射血分数[(63.81±5.67)%比(52.18±5.81)%]显著降低(P=0.001);既往心肌梗死率(21.28%比39.73%)显著升高(P=0.035);3支以上冠状动脉狭窄≥50%率(36.17%比54.79%)显著升高(P=0.046)。与无fQRS组比较,fQRS组MACE发生率(25.53%比45.21%)显著升高(P=0.030)。结论:出现fQRS的NSTEMI患者心功能显著差于无fQRS患者,有fQRS患者预示患者病情重,预后差。

Objective:To explore predictive value of fragmented QRS wave(fQRS)for prognosis in patients with acute no ST elevation myocardial infarction(NSTEMI).Methods:According to ECG measure result,120 NSTEMI patients treated in our hospital from Jan 2015 to Feb 2017 were divided into fQRS group(n=73)and no fQRS group(n=47).Both groups received same treatment.General information and incidence of MACE during one-year follow-up were compared between two groups.Results:There were no significant difference in heart rate,percentage of dyslipidemia,hypertension and diabetes mellitus between two groups(P>0.05 all).Compared with no fQRS group,there were significant reduction in left ventricular ejection fraction[(63.81±5.67)%vs.(52.18±5.81)%,P=0.001],and significant rise in percentage of previous myocardial infarction(21.28%vs.39.73%,P=0.035)and more than three coronary stenosis greater than or equal to 50%(36.17%vs.54.79%,P=0.046)in fQRS group.Compared with no fQRS group,incidence of MACE of fQRS group was higher(25.53%vs.45.21%,P=0.030).Conclusion:Cardiac function of NSTEMI patients with fQRS is significantly poorer than that of patients without fQRS,so patients with fQRS predicts their state of an illness is serious and prognosis is poor.