PCI术后新发碎裂QRS波对STEMI患者院内主要心血管不良事件的预测价值

Predictive value of new appearance of fragmented QRS wave after PCI for cardiovascular adverse events of STEMI patients

目的研究经皮冠状动脉介入术(PCI)后新发碎裂QRS波(fQRS)对ST段抬高型心肌梗死(STEMI)患者院内主要心血管不良事件(MACE)的预测价值。方法选择急诊PCI治疗的急性STEMI患者为研究对象,根据术后是否新发fQRS波分为fQRS组和非fQRS组,比较两组间心肌损伤程度及MACE的差异,采用Logistic回归模型分析MACE的影响因素。结果fQRS组磷酸肌酸激酶同工酶(CK-MB)峰值、心肌肌钙蛋白I(cTnI)峰值、MACE发生率均高于非fQRS组,TIMI血流分级低于非fQRS组(P<0.05)。经Logistic回归分析,C反应蛋白(hs-CRP)、CK-MB峰值、cTnI峰值、Grace评分、新发fQRS波是MACE的影响因素(P<0.05)。结论STEMI患者PCI术后新发fQRS波与院内MACE有关,可作为预测MACE的指标。

Aim To study the predictive value of new appearance of fragmented QRS(fQRS)wave after percutaneous coronary intervention(PCI)for in-hospital cardiovascular adverse events(MACE)of ST segment elevation myocardial infarction(STEMI)patients.Methods Acute STEMI patients who received emergency PCI treatment were selected as the research objects and divided into fQRS group and non fQRS group according to whether there was new appearance of fQRS wave after operation.The difference of myocardial injury degree and MACE between the two groups were compared,and the influencing factors of MACE were analyzed by Logistic regression model.Results The peak value of creatine kinase isoenzyme(CK-MB),the peak value of cardiac troponin I(cTnI)and the incidence of MACE of fQRS group were higher than those of non fQRS group,and the TIMI blood flow grade was lower than that of non fQRS group(P<0.05).Logistic regression analysis showed that C-reactive protein(hs-CRP),the peak value of CK-MB,the peak value of cTnI,Grace score and new fQRS wave were the influencing factors of MACE(P<0.05).Conclusion The new appearance of fQRS wave of STEMI patients after PCI is related to in-hospital MACE,which can be used as a predictor for MACE.