本文選題：碎裂QRS波 + 急性ST段抬高型心肌梗死　； 參考：《廣東醫(yī)學(xué)》2017年12期

【摘要】：目的探討碎裂QRS波(fQRS)對(duì)急性ST段抬高型心肌梗死(STEMI)患者直接冠狀動(dòng)脈介入治療(PCI)后心肌灌注及預(yù)后的預(yù)測(cè)價(jià)值。方法回顧性選擇186例STEMI行急診PIC患者,根據(jù)介入治療后有無新出現(xiàn)fQRS分為fQRS組和無fQRS組,比較術(shù)后TIMI血流(TIMI)分級(jí)、TIMI心肌灌注(TMP)分級(jí)、心電圖ST段回落、肌酸激酶同工酶(CK-MB)峰值、肌鈣蛋白(CTn I)峰值、術(shù)后7 d左室射血分?jǐn)?shù)(LVEF)、心血管事件(MACE)和異常Q波的發(fā)生率,分析fQRS發(fā)生率與LVEF、TIMI、TMP的相關(guān)性。結(jié)果 fQRS組TIMI 3級(jí)血流獲得率(51.1%)及TMP 3級(jí)灌注獲得率(46.7%)顯著低于無fQRS組(79.2%和77.1%)(P0.01);fQRS組90 min ST段回落≥50%(STR)(47.8%),顯著低于無fQRS組(75.0%)(P0.01);fQRS組CK-MB峰值(308.4±44.8 u/d L)和CTn I峰值(66.6±2.1 ng/L)均顯著高于無fQRS組(192.7±35.5 u/d L和40.8±1.8 ng/L)(P0.05);PCI術(shù)后7 d fQRS組LVEF[(35.6±5.1)%]顯著低于無fQRS組[(49.7±6.4)%](P0.05);fQRS組MACE發(fā)生率(17.8%)顯著高于無fQRS組(5.2%)(P0.05);fQRS組Q波發(fā)生率(75.6%)顯著高于無fQRS組(44.8%)(P0.01)。fQRS發(fā)生率與LVEF呈負(fù)相關(guān)(r=-0.232,P=0.02),fQRS與TIMI血流分級(jí)和TIMI 3級(jí)呈顯著負(fù)相關(guān)(r=-0.347,P=0.000;r=-0.318,P=0.002);fQRS與TMP分級(jí)和TMP3級(jí)呈顯著負(fù)相關(guān)(r=-0.370,P=0.000;r=-0.325,P=0.001)。結(jié)論 STEMI術(shù)后新出現(xiàn)fQRS波提示心肌灌注不良,fQRS是預(yù)測(cè)STEMI患者心肌灌注和預(yù)后的有用指標(biāo)。
[Abstract]:Objective to investigate the predictive value of QRS wave fQRSs in predicting myocardial perfusion and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) after direct coronary intervention. Methods 186 patients with STEMI undergoing emergency PIC were retrospectively selected and divided into fQRS group and non-fQRS group according to whether there was any new fQRS after interventional therapy. The results were compared with that in the post-operation TIMI blood flow grade and TIMI myocardial perfusion grade, St segment receding, creatine kinase isoenzyme CK-MBs peak value. Cardiac troponin I (CTN) peak, left ventricular ejection fraction (LVEF), cardiac events (fQRS) and abnormal Q wave were observed 7 days after operation. The correlation between the incidence of fQRS and LVEFV TIMIM TMP was analyzed. Results in the fQRS group, the TIMI 3 grade blood flow rate and the TMP 3 grade perfusion rate were significantly lower than those in the no fQRS group (79.2% and 77.1% respectively), and were significantly higher than those in the 90 min St segment recessions 鈮，

本文編號(hào)：1950751