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目的探讨碎裂QRS波(fQRS)评价急性心肌梗死患者PCI术后预后的预测价值。方法选取128例AMI患者作为研究对象,PCI术前常规行十二导心电图(ECG)检查和超声心动图检查,根据有无f QRS分为两组,两组患者术后1月、6月跟踪随访ECG及超声心动图,对比两组间fQRS变化及心脏形态功能改变情况,平均随访28±7月,随访两组生存时间,并使用Kaplan-Meier生存分析心血管死亡事件。结果 1fQRS波组中ST抬高型心肌梗死(STEMI)的比例高于无fQRS组,且多支冠脉血管病变较多,两组比较差异有统计学意义(p<0.05);2fQRS组左室舒张末内径(LVEDd)较大,左室射血分数(LVEF)较低,与无fQRS组比较有统计学差异(p<0.05),fQRS组心率变异性(SDNN)值低于无f RQS组,但差异无统计学意义(p>0.05);3Kaplan-Meier生存分析两组AMI患者在随访期间出现的心血管死亡事件,fQRS组生存时间、生存率明显下降,p<0.05。4两组PCI术后1月有LVEF增大及LVEDd的减小,但差异无统计学意义(p>0.05),术后6月,差异有统计学意义(p<0.05),fQRS组少数患者碎裂减轻或消失。结论 fQRS波为评价AMI患者PCI术后的临床预后提供了另一种新的便捷方法。
Objective To investigate the prognostic value of fragmented QRS wave (fQRS) in patients with acute myocardial infarction after PCI. Methods A total of 128 patients with AMI were enrolled in this study. Twelve-lead ECG and echocardiography were performed routinely before PCI, and were divided into two groups according to presence or absence of f QRS. The patients were followed up for 1 month and 6 months Follow-up ECG and echocardiography were used to compare the changes of fQRS and cardiac function between the two groups. The patients were followed up for an average of 28 ± 7 months. The survival time was followed up and Kaplan-Meier survival was analyzed for cardiovascular death. Results The proportion of STEMI in 1fQRS wave group was higher than that in non-fQRS group, and there were more coronary artery lesions in the 1fQRS wave group (p <0.05). The left ventricular (LVEDd) was higher, left ventricular ejection fraction (LVEF) was lower, there was a significant difference compared with no fQRS group (p <0.05), and heart rate variability (SDNN) , But the difference was not statistically significant (p> 0.05); 3Kaplan-Meier survival analysis of two groups of AMI patients during the follow-up of cardiovascular death events, fQRS group survival time, survival rate decreased significantly, p <0.05.4 two groups of PCI There was a significant increase in LVEF and LVEDd at 1 month after operation, but the difference was not statistically significant (p> 0.05). After 6 months, the difference was statistically significant (p <0.05) disappear. Conclusion The fQRS wave provides another new and convenient method for assessing the clinical outcome of patients with AMI after PCI.