碎裂QRS波对急性ST段抬高型心肌梗死PCI术后的预测应用

Application of Fragmented QRS Wave in the Prediction of Acute ST-segment Elevation Myocardial Infarction after PCI

目的研究碎裂QRS波对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术(PCI)后的预测应用。方法选取2016年3月—2017年3月于我院接受介入术治疗的急性ST段抬高型心肌梗死患者139例为研究对象。根据患者术后是否出现新的碎裂QRS波分为研究组(出现碎裂QRS波)66例与对照组(未出现碎裂QRS波)73例。分别比较两组患者一般资料、术后心肌灌注分级情况,各项临床指标水平,以及术后12个月主要心脏不良事件发生情况。结果研究组患者术后心肌灌注分级为0~2级的人数占比高于对照组(P<0.05)。研究组术后肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)峰值与肌钙蛋白(troponin CTnI)峰值高于对照组,左心室射血分数(left ventricular ejection fraction,LVEF)低于对照组(P均<0.05)。研究组术后12个月主要心脏不良事件发生率高于对照组(P<0.05)。结论碎裂QRS波可能是急性ST段抬高型心肌梗死介入术后心肌灌注以及预后的预测指标。

Objective To study the application of fragmented QRS wave in the prediction of acute ST-segment elevation myocardial infarction after percutaneous coronary intervention(PCI).Methods Totally 139 case of acute ST-segment elevation myocardial infarction patients who received interventional therapy in our hospital from March 2016 to March 2017 were selected as subjects.According to whether new fragmented QRS wave appeared after operation or not,the patients were divided into study group(fragmented QRS wave)with 66 cases and control group(no fragmented QRS wave)with 73 cases.The general data,the grading of myocardial perfusion,the level of clinical indicators and the occurrence of major adverse cardiac events in 12 months after operation was compared between the two groups.Results The proportion of patients with myocardial perfusion grading of 0-2 was significantly higher than that of the control group(P<0.05).The peak value of creatine kinase isoenzyme(CK-MB)and troponin(CTnI)in the study group was higher than the control group,while the left ventricular ejection fraction(LVEF)in the study group was lower than that of the control group(P all<0.05).The incidence of major adverse cardiac events in the study group 12 months after operation was significantly higher than that of the control group(P<0.05).Conclusion Fragmented QRS wave may be a predictor of myocardial perfusion and prognosis in patients with acute ST-segment elevation myocardial infarction after interventional therapy.