【摘要】：目的探討經(jīng)皮冠狀動(dòng)脈介入治療急性前壁心肌梗死病人出院時(shí)心電圖碎裂QRS波群對(duì)預(yù)后的判斷價(jià)值。方法回顧性納入了213例經(jīng)皮冠狀動(dòng)脈介入治療的急性前壁心肌梗死病人,根據(jù)病人出院前心電圖是否存在碎裂QRS波群,將病人分為碎裂QRS波群組(107例)和非碎裂QRS波群組(106例)。碎裂QRS波定義為標(biāo)準(zhǔn)12導(dǎo)聯(lián)心電圖至少存在對(duì)應(yīng)冠狀動(dòng)脈供血區(qū)域2個(gè)或2個(gè)以上連續(xù)導(dǎo)聯(lián)的QRS波群上存在多種RSR'波型(≥1個(gè)R'波,R波的頂部或S波的底部出現(xiàn)頓挫波),伴有或不伴有Q波。結(jié)果兩組平均隨訪時(shí)間對(duì)比差異無統(tǒng)計(jì)學(xué)意義(P=0.319)。經(jīng)過1年的臨床隨訪,本研究主要復(fù)合終點(diǎn)事件發(fā)生率在兩組間比較差異有統(tǒng)計(jì)學(xué)意義(P=0.001);全因病死率在碎裂QRS波群組為7.48%,在非碎裂QRS波群組為0.94%(P=0.019);心源性病死率在碎裂QRS波群組和非碎裂QRS波群組分別為5.61%和0.94%(P=0.098);隨訪期間兩組再發(fā)性急性冠脈綜合征發(fā)生率和冠狀動(dòng)脈血運(yùn)重建率對(duì)比具有相似的發(fā)生率。心力衰竭發(fā)生率在兩組之間也相似。結(jié)論在經(jīng)皮冠狀動(dòng)脈介入治療急性前壁心肌梗死病人中,出院時(shí)心電圖中存在碎裂QRS波的病人主要復(fù)合終點(diǎn)事件發(fā)生率明顯高于非碎裂QRS波的病人,其中全因病死率在存在碎裂QRS波的病人中明顯升高。
[Abstract]:Objective to evaluate the prognostic value of QRS complex in patients with acute anterior myocardial infarction treated by percutaneous coronary intervention (PCI). Methods A total of 213 patients with acute anterior wall myocardial infarction treated by percutaneous coronary intervention (PCI) were retrospectively included. According to whether there were fragmentation QRS waves in ECG before discharge, The patients were divided into fragmentation QRS wave group (107 cases) and non-fragmentation QRS wave group (106 cases). Fragmentation QRS wave is defined as the existence of multiple RSR' wave patterns (鈮，

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