ST段抬高型心肌梗死合并完全性右束支传导阻滞急诊PCI后心率变异性、QTcd和心电QRS电压影响的研究

Study on effects of emergency PCI on heart rate variability,QTcd and QRS voltage in patients with acute ST-segment elevation myocardial infarction complicated with complete right bundle branch block

目的探讨急性ST段抬高型心肌梗死(STEMI)合并完全性右束支传导阻滞行急诊经皮冠状动脉介入治疗(PCI)后,对患者心率变异性(HRV),QT校正离散度(QTcd)和心电QRS电压的影响。方法选择2019年12月至2021年12月梅州市人民医院诊断为STEMI并行急诊PCI或延期PCI患者150例,将急性STEMI合并完全性右束支传导阻滞行急诊PCI设定为观察组,急性STEMI合并完全性右束支传导阻滞行延期PCI设定为对照一组,急性STEMI无完全性右束支传导阻滞行急诊PCI设定为对照二组,每组各50例,评估其对HRV、QTcd和心电QRS电压的影响。结果治疗后,观察组QRS波群电压(aVF导联)及QTcd短于对照一组与对照二组,差异有统计学意义(P<0.05)。结论STEMI合并完全性右束支传导阻滞行PCI后,对HRV,QTcd和心电QRS电压的观测有助于临床筛选高危患者,利于远期预后。

Objective To investigate the effects of emergency percutaneous coronary intervention(PCI)on heart rate variability(HRV),QT corrected dispersion(QTcd)and ECG QRS voltage in patients with acute STsegment elevation myocardial infarction(ST EMI)complicated with complete right bundle branch block(CRBBB).Methods A total of 150 patients diagnosed with STEMI undergoing emergency PCI or delayed PCI in Meizhou People’s Hospital from December 2019 to December 2021 were included in the study.Patients diagnosed with acute STEMI combined with CRBBB undergoing emergency PCI were included in the observation group,patients diagnosed with acute STEMI combined with CRBBB undergoing delayed PCI were included in the control group 1,and patients diagnosed with acute STEMI without CRBBB undergoing emergency PCI were included in the control group 2,with 50 cases in each group.All the patients were evaluated for the effects of PCI on HRV,QTcd and ECG QRS voltage.Results After treatment,QRS group voltage(aVF lead)and QTcd in observation group were shorter than those in control group 1 and control group 2,the difference was statistically significan(P<0.05).Conclusion After PCI treatment for STEMI combined with CRBBB,the observation of HRV,QTcd and ECG QRS voltage is helpful for clinical screening of high-risk patients and long-term prognosis.